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?

This range of systolic blood pressure is classified as stage 1 hypertension according to the American College of Cardiology and the American Heart Association. Stage 1 hypertension is when blood pressure consistently ranges from 130 to 139 systolic or 80 to 89 mm Hg diastolic.At this stage of high blood pressure, health care professionals are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease, or ASCVD, such as heart attack or stroke.

Choice A is wrong because 140 to 159 is the range for stage 2 hypertension, which is more severe than stage 1.

Stage 2 hypertension is when blood pressure consistently is 140/90 mm Hg or higher.At this stage of high blood pressure, health care professionals are likely to prescribe a combination of blood pressure medications and lifestyle changes.

Choice C is wrong because 110 to 119 is the range for normal blood pressure.

Normal blood pressure is when systolic blood pressure is less than 120 mm Hg and diastolic blood pressure is less than 80 mm Hg.If your results fall into this category, stick with heart-healthy habits like following a balanced diet and getting regular exercise.

Choice D is wrong because 120 to 139 is not a valid range for systolic blood pressure.

It includes two different categories: elevated and stage 1 hypertension.

Elevated blood pressure is when readings consistently range from 120-129 systolic and less than 80 mm Hg diastolic.People with elevated blood pressure are likely to develop high blood pressure unless steps are taken to control the condition.Stage 1 hypertension, as explained above, is when systolic blood pressure ranges from 130 to 139 or diastolic blood pressure ranges from 80 to 89.

The normal range for systolic blood pressure is less than 120 mm Hg.The normal range for diastolic blood pressure is less than 80 mm Hg.

Anticoagulant drugs are medicines that prevent blood clots from forming or growing larger.

They do not dissolve existing clots or transport platelets. They work by interfering with different steps of the blood coagulation pathway, which is the process that leads to clot formation.

Choice A is wrong because anticoagulant drugs do not dissolve existing clots.

To dissolve clots, you need fibrinolytic drugs, which break down the fibrin mesh that holds the clots together.

Choice B is wrong because anticoagulant drugs do not transport platelets.

Platelets are blood cells that stick together to form clots.

Anticoagulant drugs may affect the function of platelets, but they do not move them around.

Choice C is wrong because anticoagulant drugs do not act as fibrinolytic agents.

Fibrinolytic agents are drugs that activate plasmin, an enzyme that breaks down fibrin.

Anticoagulant drugs may inhibit the formation of fibrin, but they do not break it down.

Some examples of anticoagulant drugs are warfarin, heparin, and factor Xa inhibitors.

The normal ranges for some blood tests that measure the effects of anticoagulants 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