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 C
Explanation
A. An increased risk for CNS depression is not typically associated with opioid agonist-antagonists; instead, these medications may produce a ceiling effect on sedation compared to full agonists.
B. Respiratory depression is more commonly associated with full opioid agonists rather than agonist-antagonists. Agonist-antagonists can sometimes counteract respiratory depression caused by full agonists.
C. Opioid withdrawal symptoms can occur when a client who is dependent on full agonist opioids is given an agonist-antagonist, as these medications can displace the agonist from receptors, leading to withdrawal.
D. Hypotension is a possible side effect of opioids but is not a specific concern with the use of agonist-antagonists in the context of opioid therapy.
Correct Answer is A
Explanation
A. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." is correct; St. John's wort can reduce the effectiveness of SSRIs and may increase the risk of serotonin syndrome, making it vital for the nurse to address this safety concern.
B. "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." is a valid point, but it does not specifically address the interaction with the client’s current medication.
C. "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." is misleading; the concern is not just about timing but about taking both together at all.
D. "It's very important that you comply with your prescribed treatment." while true, this response does not directly address the specific risks associated with combining St. John's wort and citalopram.