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 is because nitroglycerin patches can cause tolerance if they are used continuously, which reduces their effectiveness in preventing angina attacks. Removing the patch each evening allows the body to restore its sensitivity to the drug.

Choice A is wrong because nitroglycerin patches should be applied every 24 hours, not every 48 hours.

Applying a new patch every 48 hours would result in inadequate blood levels of the drug and increased risk of angina.

Choice B is wrong because nitroglycerin patches should not be cut in half or altered in any way.

Cutting the patch would compromise the integrity of the drug delivery system and could lead to unpredictable or excessive doses of the drug.

Choice C is wrong because nitroglycerin patches should not be taken off for 30 minutes if a headache occurs.

Headache is a common side effect of nitroglycerin due to its vasodilating action, but it usually subsides with continued use.

Taking off the patch for 30 minutes could increase the risk of angina by interrupting the steady blood levels of the drug.

The nurse should advise the client to take an analgesic such as acetaminophen for headache relief.

Pentoxifylline is a medication that improves blood flow and oxygen delivery to the tissues in patients with peripheral vascular disease (PVD), a condition that causes narrowing of the arteries in the legs.Pentoxifylline can help reduce the symptoms of intermittent claudication, which is cramping pain in the legs that occurs with walking and improves with rest.

Choice A is correct because smoking is a major risk factor for PVD and quitting smoking can improve blood flow and prevent further damage to the arteries.

Choice B is correct because prolonged sitting or standing can reduce blood flow to the legs and worsen symptoms of PVD.

Patients should avoid crossing their legs, wearing tight clothing, or exposing their legs to cold temperatures.They should also elevate their legs when resting and move them frequently.

Choice C is wrong because pentoxifylline should be taken on an empty stomach, at least one hour before or two hours after meals, to increase its absorption and effectiveness.

Choice D is wrong because physical activity is beneficial for patients with PVD and intermittent claudication.

Exercise can improve blood circulation, increase muscle strength, reduce pain, and lower cardiovascular risk factors.Patients should be encouraged to walk regularly, as tolerated, and follow a supervised exercise program if available.