The nurse is performing an assessment on a patient who will begin ...

[magmichele12]

The nurse is performing an assessment on a patient who will begin taking propranolol (Inderal) to treat hypertension. The nurse learns that the patient has a history of asthma and diabetes. The nurse will take which action?
 
  a. Administer the medication and monitor the patient's serum glucose.
  b. Contact the provider to discuss another type antihypertensive medication.
  c. Request an order for renal function tests prior to administering this drug.
  d. Teach the patient about the risks of combining herbal medications with this drug.

Question 2

The nurse is admitting a patient who has been taking minoxidil (Loniten) to treat hypertension. Prior to beginning therapy with this medication, the patient had a blood pressure of 170/95 mm Hg and a heart rate of 72 beats per minute.
 
  The nurse assesses the patient and notes a blood pressure of 130/72 mm Hg and a heart rate of 78 beats per minute, and also notes a 2.2-kg weight gain since the previous hospitalization and edema of the hands and feet. The nurse will contact the provider to discuss which intervention?
  a. Adding hydrochlorothiazide to help increase urine output
  b. Adding metoprolol (Lopressor) to help decrease the heart rate
  c. Increasing the dose of minoxidil to lower the blood pressure
  d. Restricting fluids to help with weight reduction

[allisonblackmore]

Answer to Question 1

ANS: B
Patients with chronic lung disease are at risk for bronchospasm with beta blockers, especially those like propranolol which are non-selective. Beta blockers, with the exception of carvedilol, also decrease the efficacy of many oral antidiabetic medications. The nurse should discuss a change in medications to one that does not carry this risk.

Answer to Question 2

ANS: A
Minoxidil is a direct-acting vasodilator which can cause sodium and water retention. Combining this drug with a diuretic can help reduce edema by increasing urine output. If the patient were tachycardic, a beta blocker might be added. It is not necessary to increase the minoxidil dose or to restrict fluids.

[magmichele12]

Excellent

[Dominic]

Gracias!