Author Question: A nurse prepares to administer the prescribed dose of propranolol (Inderal) to a patient recovering ... (Read 45 times)

urbanoutfitters · **on:** Jul 23, 2018

A nurse prepares to administer the prescribed dose of propranolol (Inderal) to a patient recovering from acute myocardial infarction. When the pulse rate is checked, its is 52/minute and the rhythm is regular.

What nursing action should the nurse take next?
a. Administer the drug as prescribed.
b. Only administer one half the dose and notify the prescriber.
c. Withhold the dose and document the pulse rate.
d. Withhold the dose and notify the prescriber.

Question 2

A nurse is caring for a patient who requires treatment with a beta blocker for hypertension.

The patient has a history of asthma. The nurse should anticipate that the prescriber will order which of the following antihypertensive medications, taking into consideration the patient's health history?
a. Metoprolol (Lopressor)
b. Propranolol (Inderal)
c. Pindolol (Visken)
d. Carteolol (Cartrol)

bblaney · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: D
A beta blocker, such as propranolol, should not be given with a pulse less than 60/minute, therefore the nurse should withhold the dose and notify the prescriber.
Administering the dose as prescribed would not be appropriate, because the patient's pulse rate is too slow at this time. The dose should be withheld and the prescriber notified.
It is not up to the nurse to redose the medication; that would be a violation of the Nurse Practice Act (nurses do not prescribe). Dosages can be changed only by a licensed prescriber and/or by an order left by a licensed prescriber that has sliding dosages and allows the nurse to determine the dosage within that prescribed range, depending on the patient's status.
Withholding the dose and documenting the pulse rate is appropriate but an incomplete nursing intervention. The nurse must notify the prescriber to obtain further orders related to the medication.

Answer to Question 2

ANS: A
Metoprolol is preferred to the nonselective beta blockers for patients with asthma or diabetes.
Propranolol can cause blockade of beta2 receptors in the lungs, causing bronchoconstriction; it therefore is not recommended for patients with asthma.
Pindolol can cause blockade of beta2 receptors in the lungs, causing bronchoconstriction; it therefore is not recommended for patients with asthma.
Carteolol can cause blockade of beta2 receptors in the lungs, causing bronchoconstriction; it therefore is not recommended for patients with asthma.