Author Question: The prescriber orders propranolol (Inderal) for a patient with a blood pressure reading of 200/106. ... (Read 27 times)

WWatsford · **on:** Jul 23, 2018

The prescriber orders propranolol (Inderal) for a patient with a blood pressure reading of 200/106. An electrocardiogram taken shortly afterward shows an atrioventricular (AV) block.

The nurse should immediately hold the propranolol and report this finding to the prescriber for which reason?
a. Lowering the blood pressure will require at least two different drugs.
b. Beta blockers can intensify an AV block.
c. Some reflex tachycardia may be associated with this agent.
d. The drug may cause a cough, which might further disrupt the cardiac rhythm.

Question 2

A nurse is teaching a class on hypertension to a group of African American patients. The nurse is correct to explain that African Americans with type 1 diabetes respond best to which combination of medications?

a. Angiotensin-converting enzyme (ACE) inhibitors and diuretics
b. Diuretics and calcium antagonists
c. Diuretics and beta blockers
d. ACE inhibitors and beta blockers

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

Answer to Question 1

ANS: B
Beta blockers cause blockade of cardiac beta1 receptors, which can result in reduced atrioventricular conduction.
Two different medications are not generally needed to improve a hypertensive crisis.
The dilemma is the hypertensive crisis, which may lead to AV block, not the reflex tachycardia.
Cough is not a side effect of this beta blocker and does not contribute to a cardiac dysrhythmia; this would be the least concern of the scenario.

Answer to Question 2

ANS: A
African American patients who have type 1 diabetes and proteinuria should be treated with ACE inhibitors and diuretics.
Diuretics and calcium antagonists are not the preferred treatment for African Americans with comorbid conditions.
Beta blockers are less effective in African American patients than in Caucasian patients.
ACE inhibitors and beta blockers are not the preferred combination therapy for African Americans with comorbid conditions.