A nurse caring for a client”who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

A) Orthostatic hypotension is indicated by a decrease in diastolic blood pressure of 5 mm Hg:
Orthostatic hypotension is typically defined by a decrease in systolic blood pressure of 20 mm Hg or more or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing up. Diastolic blood pressure alone is not the primary indicator of orthostatic hypotension.

B) Orthostatic hypotension is indicated by a decrease in systolic blood pressure of 5 mm Hg:
While a decrease in systolic blood pressure is a component of orthostatic hypotension, the criterion for diagnosing orthostatic hypotension is a decrease in systolic blood pressure of 20 mm Hg or more or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing up.

C) Orthostatic hypotension increases a client's risk of a fall:
This statement is correct. Orthostatic hypotension, characterized by a sudden drop in blood pressure upon standing, can lead to dizziness and lightheadedness, increasing the risk of falls, particularly in older adults.

D) Orthostatic hypotension increases a client's risk of a pulmonary emboli:
Orthostatic hypotension is not directly associated with an increased risk of pulmonary emboli. Pulmonary embolism is a separate condition involving a blockage in the pulmonary artery or its branches, typically caused by a blood clot."

A) Check the client's perianal skin integrity:
Assessing perianal skin integrity is important in the care of a client with ulcerative colitis, particularly due to the potential for diarrhea and irritation. However, this is not the first priority upon admission for an acute exacerbation.

B) Educate the patient on which foods the patient should eat:
Nutritional education is crucial in managing ulcerative colitis, but it is not the priority during the initial assessment and admission for an acute exacerbation. Stabilizing the client's condition and addressing immediate needs take precedence.

C) Investigate the client's emotional concerns:
While emotional support is important, particularly in chronic conditions like ulcerative colitis, assessing emotional concerns is not the first action required upon admission for an acute exacerbation. Physical stabilization and assessment of the client's condition are the initial priorities.

D) Review the client's electrolyte values:
This is the correct answer. During an acute exacerbation of ulcerative colitis, there is a risk of electrolyte imbalance due to diarrhea and fluid loss. Reviewing the client's electrolyte values is crucial to assess the severity of dehydration and electrolyte imbalances, which can have immediate implications for the client's treatment plan and stabilization.