The nurse would need to monitor the serum glucose levels of a client receiving which of the following medications, owing to its effects on glycogenolysis and insulin release?
A . Norepinephrine (Levophed)
B . Dobutamine (Dobutrex)
C . Propranolol (Inderal)
D . Epinephrine (Adrenalin)
Answer: D
Explanation:
(A) Norepinephrine’s side effects are primarily related to safe, effective care environment and include decreased peripheral perfusion and bradycardia.
(B) Dobutamine’s side effects include increased heart rate and blood pressure, ventricular ectopy, nausea, and headache.
(C) Propranolol’s side effects include elevated blood urea nitrogen, serum transaminase, alkaline phosphatase, and lactic dehydrogenase.
(D) Epinephrine increases serum glucose levels by increasing glycogenolysis and inhibiting insulin release. Prolonged use can elevate serum lactate levels, leading to metabolic acidosis, increased urinary catecholamines, false elevation of blood urea nitrogen, and decreased coagulation time.