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 A
Explanation
A. "I'll use my electric razor for shaving." This is correct as using an electric razor helps prevent cuts, which is important since warfarin increases bleeding risk.
B. "I'll be sure to eat foods with lots of vitamin K." Vitamin K reduces the effectiveness of warfarin; clients should be consistent with their intake of vitamin K to avoid fluctuations in INR.
C. "It's okay to have a couple of glasses of wine with dinner." Alcohol can increase the effect of warfarin and the risk of bleeding. Clients should avoid or limit alcohol intake.
D. "I'll take aspirin for my headaches." Aspirin also has anticoagulant effects and can increase bleeding risk when taken with warfarin.
Correct Answer is B
Explanation
A. "Your heart condition is caused from stiffening of the walls of the ventricles." Stiffening of the ventricular walls describes restrictive cardiomyopathy, not DCM.
B. "Your heart condition is caused by excessive stretching of the ventricles." DCM involves excessive stretching and thinning of the ventricular walls, leading to impaired contraction.
C. "Your heart condition is caused when the ventricular tissue becomes fibrous and fatty." This describes arrhythmogenic right ventricular dysplasia, not DCM.
D. "Your heart condition is caused by thickening of the ventricular walls and septum." This describes hypertrophic cardiomyopathy, not DCM.