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?

The nurse should contact the provider and ask the patient if they are feeling light headed or dizzy.

Choice A is wrong because administering the medication could worsen the patient’s condition.Furosemide is a diuretic that can cause dehydration, electrolyte imbalance, and hypotension.The patient already has a low serum potassium level of 2.8 mEq/L, which is below the normal range of 3.5 to 5.0 mEq/L.Giving furosemide could lower the potassium level further and increase the risk of cardiac arrhythmias.The patient also has a significant drop in blood pressure from lying to sitting position, which indicates orthostatic hypotension.Giving furosemide could lower the blood pressure more and cause dizziness, fainting, or falls.

Choice D is wrong because encouraging the patient to get up quickly and walk around could also cause dizziness, fainting, or falls due to orthostatic hypotension.The patient should be advised to change positions slowly and carefully, and to avoid activities that require alertness until their blood pressure stabilizes.

Choice E is wrong because holding the medication without contacting the provider could delay the appropriate treatment for the patient’s fluid retention.The nurse should notify the provider of the patient’s vital signs, laboratory results, and symptoms, and follow their orders regarding the medication dosage or alternative therapy.

Angiotensin receptor blockers (ARBs) are a class of drugs that block the action of angiotensin II, a hormone that causes blood vessels to constrict and raise blood pressure. Examples of ARBs include losartan, valsartan, candesartan, and irbesartan.ARBs are used to treat hypertension, heart failure, and chronic kidney disease.

Choice A is wrong because calcium channel blockers (CCBs) are a class of drugs that prevent calcium from entering the cells of the heart and blood vessels, causing them to relax and lower blood pressure.

Examples of CCBs include amlodipine, diltiazem, verapamil, and nifedipine.CCBs are used to treat hypertension, angina, and arrhythmias.

Choice B is wrong because beta blockers are a class of drugs that reduce the heart rate and force of contraction, lowering the cardiac output and blood pressure.

Examples of beta blockers include atenolol, metoprolol, propranolol, and bisoprolol.Beta blockers are used to treat hypertension, angina, heart failure, and arrhythmias.

Choice C is wrong because platelet inhibitors are a class of drugs that prevent platelets from clumping together and forming blood clots.

Examples of platelet inhibitors include aspirin, clopidogrel, ticagrelor, and prasugrel.Platelet inhibitors are used to prevent or treat cardiovascular events such as heart attack or stroke.

Choice E is wrong because ACE inhibitors are a class of drugs that inhibit the enzyme that converts angiotensin I to angiotensin II, reducing the production of this vasoconstrictor hormone.

Examples of ACE inhibitors include lisinopril, enalapril, ramipril, and captopril.ACE inhibitors are used to treat hypertension, heart failure, and chronic kidney disease.