A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension.
The nurse should recognize which of the following conditions is a contraindication for taking propranolol?

Urecholine is the brand name of bethanechol, a drug that belongs to the class of cholinergics, genitourinary.

It is used to treat urinary retention by stimulating the bladder to contract and empty.Urecholine can be taken orally or by injection.

Choice A is wrong because adrenergic drugs are those that activate the sympathetic nervous system, which is responsible for the fight-or-flight response.Adrenergic drugs can cause relaxation of the bladder and urinary retention, not contraction and emptying.

Choice B is wrong because anticholinergic drugs are those that block the action of acetylcholine, a neurotransmitter that mediates the parasympathetic nervous system, which is responsible for the rest-and-digest response.Anticholinergic drugs can also cause relaxation of the bladder and urinary retention, not contraction and emptying.

Choice D is wrong because adrenergic blockers are those that inhibit the action of adrenergic receptors, which are activated by adrenergic drugs or by the natural neurotransmitters norepinephrine and epinephrine.Adrenergic blockers can have various effects on the bladder depending on the type and location of the receptors they block, but they are not used to treat urinary retention.

Anticoagulants are medicines that increase the time it takes for blood to clot.They do not dissolve existing clots, but they can stop them from getting bigger or prevent new clots from forming.Anticoagulants work by interfering with different steps of the blood coagulation pathway, which is a complex process that involves many clotting factors.

Choice A is wrong because anticoagulants do not dissolve existing clots.To dissolve clots, you need medicines called thrombolytics or fibrinolytics, which break down the fibrin that holds the clots together.

Choice B is wrong because anticoagulants do not transport platelets.

Platelets are blood cells that help with clotting by sticking together and forming a plug at the site of an injury.Anticoagulants may affect the function of platelets, but they do not move them around.

Choice D is wrong because anticoagulants do not increase blood viscosity.

Viscosity is a measure of how thick and sticky a fluid is.

Anticoagulants are sometimes called blood thinners, but they do not actually change the viscosity of blood.They just make it less likely to clot.

Normal ranges for blood clotting tests vary depending on the type of test and the laboratory that performs it.

Some common tests and their normal ranges are:

• Prothrombin time (PT): 11 to 13.5 seconds

• International normalized ratio (INR): 0.8 to 1.2

• Activated partial thromboplastin time (aPTT): 25 to 35 seconds

• Anti-factor Xa: 0.3 to 0.7 units/mL

• D-dimer: less than 0.5 mcg/mL