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A nurse is caring for a client who has been prescribed propranolol for angina. After administering the drug, which of the following would the nurse do?
- A. Ask about relief of symptoms and record responses on the chart
- B. Determine signs of infection in the client
- C. Monitor for sudden decrease in urine output
- D. Monitor for sudden increase in intraocular pressure
Correct Answer: A
Rationale: The nurse should ask about the relief of symptoms and record the responses on the client's chart. Determining the signs of infection in the client is part of the nurse's preadministration assessment, not the ongoing assessment. The nurse need not monitor the client for a sudden decrease in urine output and a sudden increase in intraocular pressure for a client receiving propranolol therapy for angina.
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A nurse is preparing to administer propranolol to a client for the treatment of cardiac arrhythmias. The nurse checks the client's apical pulse rate and blood pressure before administration and notes that the pulse rate is below 60 bpm. Which of the following would the nurse do next?
- A. Provide proper ventilation to the client
- B. Delay drug administration for some time
- C. Withhold the drug and contact the primary health care provider
- D. Immediately give oxygen via face mask
Correct Answer: C
Rationale: The nurse should withhold the drug and contact the primary health care provider if the pulse rate of the client is below 60 bpm. Providing proper ventilation to the client, delaying drug administration for some time, or providing oxygen support to the client would be inappropriate for this client.
The nurse should observe elderly clients taking metoprolol (Lopressor) for which of the following adverse effects as they are more likely to occur in elderly clients?
- A. Hyperglycemia
- B. Heart failure
- C. Peripheral vascular insufficiency
- D. Confusion
- E. Worsening angina
Correct Answer: B,C,D,E
Rationale: The nurse should observe elderly clients taking metoprolol (Lopressor) for confusion, heart failure, worsening angina, shortness of breath, and peripheral vascular insufficiency.
A nurse recognizes the class of medication being administered to help plan ongoing assessment and client education. The nurse would identify which drug as an example of a b-adrenergic blocker?
- A. Carvedilol (Coreg)
- B. Propranolol (Inderal)
- C. Metoprolol (Lopressor)
- D. Atenolol (Tenormin)
- E. Labetalol (Trandate)
Correct Answer: B,C,D
Rationale: Propranolol, metoprolol, and atenolol are b-adrenergic blockers, but carvedilol and labetalol are a/b-adrenergic blockers.
A nurse would closely monitor which client for an increase in possible adverse reactions after administering propranolol?
- A. Clients with asthma
- B. Clients with hyperlipidemia
- C. Clients with diabetes
- D. Clients with peptic ulcer disease
- E. Clients with migraine headaches
Correct Answer: A,C,D
Rationale: A nurse should carefully observe clients with asthma (bronchospasm can result with the use of nonselective b blockers) and diabetes (b blockers can mask the symptoms of hypoglycemia) during the use of propranolol (Inderal), a nonselective b blocker. The drug also should be used cautiously in clients with peptic ulcer disease.
Which of the following adverse reactions would the nurse include in the teaching plan for a client who is prescribed labetalol?
- A. Hypoglycemia
- B. Insomnia
- C. Drowsiness
- D. Tachycardia
- E. Fatigue
Correct Answer: B,C,E
Rationale: Adverse effects from the use of a/b-adrenergic blockers like labetalol include fatigue, dizziness, hypotension, drowsiness, insomnia, weakness, diarrhea, dyspnea, chest pain, bradycardia, and skin rash.