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Visual and Auditory ProblemsMedical-Surgical Nursing

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Which of the beta adrenergic blockers can be used in clients that have COPD or asthma because it is cardioselective (B1 blocker)?
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Betaxolol (Betoptic)
What are the side effects for betaxolol?
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Transient discomfort, rare cases have reported bradycardia, heart block, pulmonary distress, headache or depression.
Carteolol (Ocupress), Levobunolol (Betagen), Metipranolol (OptiPranolol) and Timilol maleate (Timoptic/Isatol) can cause what side effects?
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Transient discomfort, blurred vision, photophobia, blepharoconjunctivitis, bradycardia, decreased BP, bronchospasm, headache or depression.
What are the nursing considerations for patients on betaxolol (Betoptic)?
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It is contraindicated in patients with bradycardia, cardiogenic shock, or overt cardiac failure. Can have an additive effect with other B1 blockers.
What are the nursing considerations for clients on Carteolol (Ocupress), Levobunolol (Betagen), Metipranolol (OptiPranolol) or Timilol maleate (Timoptic/Isatol)?
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Contraindicated for patients with bradycardia, cardiogenic shock, overt cardiac failure, or who have asthma or COPD. It has an additive effect with other beta blockers.
How do dipivefrin (Propine) and epinephrine work to reduce symptoms in glaucoma patients?
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They decrease aqueous humor production and enhance outflow capability.
What are the nursing considerations for patients on Epinephrine or dipivefrin (Propine)?
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They shouldn't be used in people with narrow angle glaucoma and the patient should be taught punctal occlusion if they are at risk for systemic reactions.
What are the side effects of dipivefrin (Propine) and epinephrine?
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Ocular discomfort, redness, tachycardia, hypertension (may be more pronounced with epinephrine)
How does the alpha adrenergic agonist, Lantanoprost (Xalatan) work?
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It is a Prostaglandin F analog (it is a synthetic prostaglandin that binds to a prostaglandin receptor to decrease intraocular pressure)
Apraclonidine (Lopidine), and Brimonidine (Alphagan) are alpha adrenergic agonists that have the same side effects. They are:
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Ocular redness and irregular heart rate
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What drug is commonly administered both before and after Argon Laser trabeculoplasty (ALT) or iridotomies to control or prevent acute post-laser increased intraocular pressure?
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Apraclonidine (Lopidine) or Brimonidine (Alphagan)
What are the side effects associated with the alpha adrenergic agonist, latanoprost (Xalatan)?
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Increased brown iris pigmentation, ocular discomfort, and redness, dryness, itching, and foreign body sensation
What special education should a nurse include when a patient is prescribed latanoprost (Xalatan)?
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Not to exceed one drop per evening and to remove contact lenses at lease 15 minutes prior to instilling
Which of the alpha adrenergic agonists used to treat acute and chronic glaucoma is also a beta adrenergic agonist?
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Dipivefrin (Propine)
What is another word used to describe cholinergic agents?
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Miotics (an agent that causes the pupil to contract)
What cholinergic agents are used to treat acute and chronic glaucoma?
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Carbachol (Isopto Carbachol), and Pilocarpine (Akarpine, Isopto Carpine, Pilocar, Pilopine, Piloptic, Pilostat)
___________ agents are parasympathomimetics that stimulate iris sphincter contraction, causing miosis and opening of the trabecular meshwork which facilitates aqueous humor outflow.
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Cholinergic/Miotic (Carbachol & Pilocarpine)
What is the difference Carbachol and Pilocarpine's method of action?
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They work exactly the same except Carbachol also partially inhibits cholinesterase (which causes a decrease in intraocular pressure)
What are the common side effects from Carbachol (Isopto Carbachol) and Pilocarpine?
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Transient ocular discomfort, headache, brow ache, blurred vision, decreased dark adaptation, syncope, salivation, dysrhythmias, vomiting, diarrhea, hypotension, and rarely, retinal detachment in susceptible individuals
For patients on cholinergic agents like Pilocarpine and Carbachol, what should a nurse be sure to inform/caution the patient about?
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Decreased visual acuity, particularly in dim light
How do carbonic anhydrase inhibitors help patients with acute or chronic glaucoma?
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They decrease aqueous humor production
  
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