A nurse is collecting data from a client who has hypertension and a prescription for propranolol. A history of which of the following conditions should be reported to the provider?
Depression
Glaucoma
Migraine
Heart failure
The Correct Answer is D
A. Depression: While propranolol can sometimes worsen symptoms of depression, this is not as critical as the impact on conditions like heart failure.
B. Glaucoma: Propranolol does not typically affect glaucoma; however, some beta-blockers are used to treat glaucoma.
C. Migraine: Propranolol is sometimes used to prevent migraines, so a history of migraines would not require discontinuation.
D. Heart failure: Propranolol can exacerbate heart failure by reducing myocardial contractility. Clients with heart failure require careful monitoring or an alternative medication.
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Correct Answer is D
Explanation
A. Overweight. While weight can affect medication metabolism, it does not specifically increase risk with pseudoephedrine.
B. Migraine headaches. Migraine headaches are not contraindicated with pseudoephedrine, although some stimulants can increase headaches.
C. Eczema. Pseudoephedrine does not typically affect eczema.
D. Hypertension. Pseudoephedrine is a decongestant that can increase blood pressure, so it should be used with caution in clients with hypertension.
Correct Answer is A
Explanation
A. "Cardiac rehabilitation cannot undo the damage to your heart, but it can help you get back to your previous level of activity safely." This response is therapeutic and educative, helping the client understand that while damage cannot be reversed, rehabilitation supports safe recovery and improved quality of life.
B. "Your doctor is the expert here, and I'm sure he would only recommend what is best for you." This response does not address the client’s concerns and lacks supportive or educational value.
C. "You are probably right and I agree with you, but I still think you should go." This dismissive response fails to provide support, education, or empathy.
D. "It's not unusual to feel that way at first, but once you learn the routine, you'll be fine." Although this statement offers some support, it lacks the educational element needed to address the client’s concerns about the purpose of rehabilitation.