The nurse provides a client with a dose of the beta-selective adrenergic agonist isoproterenol. Which assessment finding indicates the medication is effective?
Constricted pupils
Warm, dry skin
Increased heart rate
Decreased urine output
The Correct Answer is C
A. Constricted pupils are not an expected response to isoproterenol, which generally causes dilation of the pupils due to sympathetic stimulation.
B. Warm, dry skin is not a direct indicator of the effectiveness of isoproterenol; it could result from various factors unrelated to the medication's action.
C. Increased heart rate indicates that isoproterenol, which is a beta-agonist, is effectively stimulating the beta-adrenergic receptors, leading to increased cardiac output and heart rate.
D. Decreased urine output is not a sign of effectiveness and could indicate adverse effects such as reduced renal perfusion.
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Correct Answer is D
Explanation
A. By directly relaxing vascular smooth muscle is not how lisinopril primarily works; it does not act directly on smooth muscle but rather affects hormonal pathways.
B. By blocking aldosterone from binding to mineralocorticoid receptors is a secondary effect of the angiotensin-converting enzyme (ACE) inhibitors but not the primary action of lisinopril itself.
C. By blocking the movement of calcium ions into arterial smooth muscles describes the action of calcium channel blockers, not ACE inhibitors like lisinopril.
D. By inhibiting the transformation of angiotensin I to angiotensin II is the correct answer because lisinopril inhibits the ACE enzyme, reducing the production of angiotensin II, which lowers blood pressure and decreases strain on the heart.
Correct Answer is A
Explanation
A. A reduced plasma albumin level can lead to increased free drug levels in the bloodstream, raising the risk of drug toxicity, particularly for highly protein-bound medications.
B. Decreased therapeutic effects are less likely because the decrease in albumin can lead to higher free drug concentrations, which may actually increase effects rather than decrease them.
C. Altered drug absorption is generally not directly influenced by plasma albumin levels; it relates more to gastrointestinal factors.
D. Increased drug metabolism is not a direct consequence of lower albumin levels; instead, the concern is primarily about increased free drug concentrations and potential toxicity.