A client has recently begun medication therapy with propranolol ...

[Garrulous]

A client has recently begun medication therapy with propranolol (Inderal). The long-term care nurse should plan to notify the physician if which of the following assessment findings is noted?
 
  1. Complaints of insomnia
  2. Audible expiratory wheezes
  3. Decrease in heart rate from 86 to 78 beats/min
  4. Decrease in blood pressure from 162/90 to 136/84 mm Hg

Question 2

The nurse has a written prescription to discontinue an intravenous (IV) line. The nurse obtains which of the following supplies from the unit supply area for use in applying pressure to the site after removing the IV catheter?
 
  1. Band-Aid
  2. Alcohol swab
  3. Betadine swab
  4. Sterile 2 2 gauze

[tanna.moeller]

Answer to Question 1

2

Rationale: Propranolol (Inderal) is a beta-blocker. Audible expiratory wheezes could indicate bronchospasm, a serious adverse reaction. Beta blockers that are not cardioselective, such as propranolol, may induce this reaction, particularly in clients with chronic obstructive pulmonary disease (COPD) or asthma. A normal decrease in blood pressure and heart rate is expected. Insomnia is a frequent mild side effect and should continue to be monitored.

Answer to Question 2

4

Rationale: A dry sterile dressing, such as sterile 2 2 gauze, is used to apply pressure to the dis-continued IV site. This material is absorbent, sterile, and nonirritating. A Betadine swab or alco-hol swab would irritate the opened puncture site and would not stop the blood flow. A Band-Aid may be used to cover the site after hemostasis has occurred.

[Garrulous]

Excellent

[cpetit11]

TYSM