During assessment a patient says, I took my blood pressure at ...

[pragya sharda]

During assessment a patient says, I took my blood pressure at home and it was high. I have been taking my husband's propranolol (Inderal) for the last week. The nurse is especially concerned about this action when it is noted that the patient has which preexisting conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
 
  1. Obesity
  2. Diabetes mellitus
  3. COPD
  4. Asthma
  5. Rheumatoid arthritis

Question 2

The nurse is taking the initial history of a patient admitted to the hospital for hypertension. The physician has ordered a beta-adrenergic blocker. Which statement by the patient does the nurse recognize as most significant?
 
  1. I don't handle stress well; I have a lot of diarrhea.
  2. When I have a migraine headache, I need to have the room darkened.
  3. My father died of a heart attack when he was 48-years-old.
  4. I have always had problems with my asthma.

[abro1885]

Answer to Question 1

2,3,4
Rationale 1: While obesity may be contributing to the patient's hypertension, use of propranolol (Inderal) is not contraindicated.
Rationale 2: Beta blockers may cause hyperglycemia or hypoglycemia and may mask the symptoms of hypoglycemia in patients with diabetes.
Rationale 3: Beta blockers may cause significant bronchial constriction.
Rationale 4: Beta blockers may cause significant bronchial constriction.
Rationale 5: Beta blockers are not contraindicated for use in patients with rheumatoid arthritis.

Global Rationale: Beta blockers may cause hyperglycemia or hypoglycemia and may mask the symptoms of hypoglycemia in patients with diabetes. Beta blockers may cause significant bronchial constriction. While obesity may be contributing to the patient's hypertension, use of propranolol (Inderal) is not contraindicated. Beta blockers are not contraindicated for use in patients with rheumatoid arthritis.

Answer to Question 2

4
Rationale 1: There is no correlation between increased stress, diarrhea, and beta-adrenergic blockers.
Rationale 2: Beta-adrenergic blockers do not affect migraine headaches.
Rationale 3: Having a father who died of a heart attack when he was young is significant but has no correlation to this patient and use of beta-adrenergic blockers.
Rationale 4: With increased doses, beta-adrenergic blockers can slow the heart rate and cause bronchoconstriction . They should be used with caution in patients with asthma.
Global Rationale: With increased doses, beta-adrenergic blockers can slow the heart rate and cause bronchoconstriction . They should be used with caution in patients with asthma. Beta-adrenergic blockers do not affect migraine headaches. Having a father who died of a heart attack when he was young is significant but has no correlation to this patient and use of beta-adrenergic blockers. There is no correlation between increased stress, diarrhea, and beta-adrenergic blockers.

[pragya sharda]

YES! Correct, THANKS for helping me on my review

[nyrave]

Gracias!