A client who suffers from hypertension and headaches is prescribed propranolol. The nurse would educate the client on which side effects associated with this medication? (Select All that Apply.)
Masking of hypoglycemia
Tachycardia
Bradycardia
Orthostatic Hypotension
Hypertension
Correct Answer : A,C,D
A) Masking of hypoglycemia: Propranolol can mask the symptoms of hypoglycemia, such as tachycardia, which is important for clients with diabetes to be aware of. This means that while they may have low blood sugar, they might not experience the typical warning signs due to the medication's effects on the autonomic nervous system.
B) Tachycardia: Propranolol is a beta-blocker that is used to reduce heart rate and blood pressure. Therefore, tachycardia is not a side effect associated with this medication; in fact, it generally works to prevent this condition.
C) Bradycardia: Bradycardia, or a slow heart rate, is a common side effect of propranolol due to its action on beta-adrenergic receptors. Clients should be educated about monitoring their heart rate and reporting any significant drops.
D) Orthostatic Hypotension: This is a potential side effect of propranolol, especially when starting the medication or increasing the dose. Clients should be advised to rise slowly from sitting or lying positions to minimize the risk of dizziness or fainting.
E) Hypertension: Propranolol is prescribed to manage hypertension, so it should not be expected as a side effect. In fact, it is intended to lower blood pressure, and clients should be educated that they should not experience increased hypertension while taking this medication.
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Correct Answer is ["D","E"]
Explanation
A) Aspirin: While aspirin is an antiplatelet medication that can help prevent further clot formation, it does not have thrombolytic properties and does not directly lyse existing clots. Therefore, it is not appropriate for this purpose.
B) Heparin: Heparin is an anticoagulant used to prevent the extension of existing clots and reduce the risk of new clots forming, but it does not dissolve existing clots. It helps manage deep vein thrombosis but does not have thrombolytic activity.
C) Warfarin (Coumadin): Warfarin is an oral anticoagulant that is used to prevent new clot formation and the growth of existing clots. However, like heparin, it does not actively lyse or dissolve existing clots.
D) Alteplase (Activase): This medication is a thrombolytic agent that actively dissolves blood clots by activating plasminogen to plasmin, leading to clot breakdown. It is appropriate for use in cases of deep vein thrombosis when clot lysis is indicated.
E) Anistreplase (Eminase): Similar to alteplase, anistreplase is another thrombolytic agent used to lyse existing clots. It acts by converting plasminogen to plasmin, effectively breaking down fibrin in clots, making it suitable for the treatment of deep vein thrombosis.
Correct Answer is D
Explanation
A) Pulse oximetry of 92%: While a pulse oximetry reading of 92% is slightly below normal, it is not a definitive reason to hold verapamil. This reading indicates mild hypoxemia, but it does not directly contraindicate the use of verapamil. Other factors should be considered before making a decision based solely on this value.
B) Pulse of 78: A pulse rate of 78 beats per minute is within the normal range for adults and does not warrant holding verapamil. This finding alone does not indicate any immediate concerns related to the administration of the medication.
C) Respiratory rate of 12: A respiratory rate of 12 breaths per minute is within the normal range for adults. This finding does not provide any indication that verapamil should be withheld. It is important to consider other clinical factors when assessing the appropriateness of medication administration.
D) History of myocardial infarction a week ago: Verapamil, a calcium channel blocker, can have significant effects on cardiac function. Administering it to a client who recently experienced a myocardial infarction (heart attack) could exacerbate cardiac issues and lead to complications. Therefore, it is crucial to hold the medication and consult with the healthcare provider before proceeding.