A nurse is reviewing the health history of a client diagnosed with angina pectoris and has a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the client's health history should the nurse report to the provider?
The client has a history of bronchial asthma.
The client has a history of migraine headaches.
The client has a history of hypertension.
The client has a history of hypothyroidism.
The Correct Answer is A
A. The client has a history of bronchial asthma: Propranolol is a non-selective beta-blocker and can potentially exacerbate bronchospasm in individuals with asthma due to its beta-blocking effects on beta-2 receptors in the bronchioles. Therefore, this finding should be reported to the provider for further assessment and consideration of alternative medications.
B. The client has a history of migraine headaches: Propranolol is commonly used prophylactically to prevent migraine headaches, so this finding is not a contraindication for its use and does not require immediate reporting to the provider.
C. The client has a history of hypertension: Propranolol is often prescribed for hypertension, so this finding is expected and not a cause for concern.
D. The client has a history of hypothyroidism: While propranolol can affect thyroid function tests, a history of hypothyroidism alone is not a contraindication for its use, and it does not
require immediate reporting to the provider. However, thyroid function should be monitored during therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Condition Most Likely Experiencing: Heart failure.
The client presents with signs and symptoms consistent with heart failure, including cardiomegaly, bibasilar pleural congestion on chest x-ray, elevated BNP level, and vital signs indicating hypertension (BP 146/98 mm Hg), tachycardia (pulse rate 106/min), and tachypnea (respirations 24/min). Additionally, the client is prescribed medications commonly used to manage heart failure, such as digoxin and carvedilol, and is receiving a diuretic (furosemide) to address fluid overload associated with heart failure.
Action to Take:
Elevate the head of the bed: Elevating the head of the bed helps reduce venous return to the heart, decreasing preload and potentially alleviating symptoms of heart failure, such as dyspnea and orthopnea. It can also help prevent aspiration in clients with compromised cardiac function. Encourage intake of a low-sodium diet: A low-sodium diet is essential in managing heart failure as it helps reduce fluid retention and edema by decreasing fluid volume overload. Sodium restriction helps minimize fluid accumulation, which is crucial in preventing exacerbations of heart failure.
Parameter to Monitor:
Urinary output: Monitoring urinary output is important in assessing fluid balance and response to diuretic therapy in clients with heart failure. Decreased urinary output may indicate worsening heart failure or inadequate response to diuretic therapy, whereas increased output may suggest over-diuresis or improvement in heart failure symptoms.
Blood pressure: Monitoring blood pressure helps assess the effectiveness of treatment in managing heart failure and controlling hypertension, a common comorbidity. Hypertension can exacerbate heart failure, so monitoring blood pressure trends helps guide adjustments in medication therapy to achieve optimal blood pressure control and improve cardiac function.
Correct Answer is C
Explanation
A. Chemotherapy is only used for palliation: While chemotherapy can be used for palliative care to relieve symptoms and improve quality of life in advanced cancer, it is also used with curative intent in some cases, especially when cancer is diagnosed early or is responsive to chemotherapy.
B. Chemotherapy cures prostate cancer that has metastasized to the bone: Chemotherapy alone is generally not curative for prostate cancer that has metastasized to the bone. It may help slow disease progression, relieve symptoms, or prolong survival, but it is not typically curative on its own.
C. Chemotherapy is used in conjunction with other treatment modalities in this type of cancer: Chemotherapy is often used in combination with other treatment modalities such as hormone therapy, radiation therapy, or surgery in the management of prostate cancer with bone metastasis. The goal is to target cancer cells using multiple approaches to achieve the best possible outcome for the patient.
D. Chemotherapy makes the body fluid a biohazard: Chemotherapy drugs can be excreted in body fluids such as urine, saliva, and sweat, making them potentially hazardous. However, this statement does not specifically address the role of chemotherapy in the treatment of prostate cancer with bone metastasis.
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