The patient with type 1 diabetes mellitus is receiving ...

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The patient with type 1 diabetes mellitus is receiving propranolol (Inderal). What is the best outcome for this patient?
 
  1. The patient will maintain blood glucose within normal limits.
  2. The patient will decrease the required number of calories/day.
  3. The patient will maintain adequate peripheral circulation.
  4. The patient will perform activities of daily living.

Question 2

The nurse completes medication education with a patient who receives propranolol (Inderal). The nurse evaluates the education as effective when the patient makes which statement?
 
  1. I must take my pulse every day and call my doctor if it is higher than 100.
  2. I must call my doctor if my anxiety increases and I start worrying again.
  3. I must take my pulse every day and call my doctor if it is less than 60.
  4. I must call my doctor if I lose more than three pounds a week.

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Answer to Question 1

Correct Answer: 1
Rationale: Propranolol (Inderal) should be used cautiously in patients with type 1 diabetes mellitus due to its hypoglycemic effects. Peripheral circulation should not be affected by propranolol (Inderal). Activities of daily living are important for any patient, but should not be affected by propranolol (Inderal). Propranolol (Inderal) should not affect the patient's appetite; the patient should not decrease calories.

Answer to Question 2

Correct Answer: 3
Rationale: Beta blockers decrease contractions of the myocardium and decrease the speed of conduction through the atrioventricular (AV) node. This can result in a significant decrease in heart rate, and the patient should let the physician know if his heart rate falls below 60. Beta blockers decrease, not increase, the heart rate. Beta blockers predispose the patient to weight gain, not weight loss. Beta blockers actually decrease, not increase, anxiety.

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