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?

LDL cholesterol is sometimes called “bad” cholesterol because it can build up on the walls of the blood vessels and cause health problems, such as heart disease and stroke.High levels of LDL cholesterol raise your risk for cardiovascular disease. Therefore, decreasing LDL cholesterol levels can lower your risk and improve your health.

Choice A is wrong because increasing LDL cholesterol levels would have the opposite effect of decreasing them.It would increase your risk for cardiovascular disease and plaque buildup in your arteries.

Choice B is wrong because increasing HDL cholesterol levels is not enough to decrease the risk of cardiovascular disease.HDL cholesterol is sometimes called “good” cholesterol because it can move LDL cholesterol from the blood to the liver, where it is broken down and removed from the body.

However, HDL cholesterol levels alone are not a good indicator of your cardiovascular health.You also need to consider your total cholesterol, LDL cholesterol and triglyceride levels.

Choice D is wrong because decreasing HDL cholesterol levels would also increase your risk for cardiovascular disease.HDL cholesterol helps to lower LDL cholesterol levels and protect your blood vessels from plaque buildup.

Therefore, decreasing HDL cholesterol levels would reduce this protective effect and make you more vulnerable to heart disease and stroke.

The ideal ranges for cholesterol levels are as follows:

• Total cholesterol: below 200 mg/dL

• LDL cholesterol: less than 100 mg/dL

• HDL cholesterol: above 40 mg/dL for men and above 50 mg/dL for women

You can lower your LDL cholesterol levels and increase your HDL cholesterol levels by making healthy lifestyle changes, such as eating a balanced diet, exercising regularly, quitting smoking, managing stress and taking medication if prescribed by your doctor.

Exposure to cold temperatures should be avoided by the patient with peripheral vascular disease such as Raynaud’s disease.

This is because cold temperatures can trigger vasospasm, which is a sudden narrowing of the small arteries in the fingers or toes, limiting blood flow and causing pain, numbness and color changes.

Choice A is wrong because wearing warm mitten gloves can help prevent or reduce the severity of Raynaud’s attacks by keeping the hands warm.

Choice B is wrong because wearing socks can also help protect the feet from cold exposure and prevent or reduce Raynaud’s attacks.

Choice D is wrong because engaging in regular exercise can improve blood circulation and reduce the frequency and duration of Raynaud’s attacks.However, exercise should be done with caution and proper clothing to avoid injury or frostbite to the affected areas.

Normal ranges for peripheral vascular disease are not applicable, as it is a condition that affects the blood vessels and not a specific blood test or measurement.

However, some tests that can help diagnose peripheral vascular disease or its underlying causes are blood pressure measurement, ankle-brachial index, Doppler ultrasound, angiography, blood tests for cholesterol, glucose, clotting factors and inflammatory markers.