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 potassium sparing diuretics do not lower potassium levels in the blood, unlike some other types of diuretics. Potassium is an important electrolyte that helps regulate nerve and muscle functions, especially the heart. Low potassium levels can cause irregular heartbeats and other problems.Therefore, people who take diuretics should avoid foods that are high in potassium, such as bananas, oranges, tomatoes, and potatoes, unless they are taking potassium sparing diuretics.

Choice A is wrong because thiazide diuretics, such as hydrochlorothiazide, can cause low potassium levels in the blood and increase the risk of arrhythmias.

People who take thiazide diuretics may need to take potassium supplements or eat more potassium-rich foods.

Choice B is wrong because osmotic diuretics, such as mannitol, do not affect potassium levels in the blood.

They work by increasing the amount of water in the urine, but do not alter the electrolyte balance.

Osmotic diuretics are mainly used to treat brain swelling or glaucoma.

Choice D is wrong because loop diuretics, such as lasix, can also cause low potassium levels in the blood and increase the risk of arrhythmias.

People who take loop diuretics may also need to take potassium supplements or eat more potassium-rich foods.

Normal ranges for potassium in the blood are 3.5 to 5.0 millimoles per liter (mmol/L).

Nitroglycerin sublingual is a medication that is used to treat chest pain or angina by relaxing the blood vessels and reducing the oxygen demand of the heart.A common side effect of nitroglycerin sublingual is headache, which may be severe and throbbing.Headache is often a sign that the medication is working.Other possible side effects include flushing, dizziness, lightheadedness, nausea, vomiting, fast heart rate, numbness, tingling, burning pain, rash, hives, sweating, pale skin, difficulty breathing and allergic reaction.

Choice A is wrong because nausea is not the most common adverse effect of nitroglycerin sublingual.Nausea may occur in some people, but it is usually mild and transient.

Choice B is wrong because bradycardia (slow heart rate) is not a common adverse effect of nitroglycerin sublingual.Nitroglycerin sublingual may cause tachycardia (fast heart rate) in some people as a result of vasodilation and reflex stimulation of the heart.

Choice C is wrong because hypertension (high blood pressure) is not a common adverse effect of nitroglycerin sublingual.Nitroglycerin sublingual may cause hypotension (low blood pressure) in some people due to its vasodilating action.Hypotension may lead to lightheadedness, fainting or shock in severe cases.

The normal range for blood pressure is less than 120/80 mmHg for adults.

The normal range for heart rate is 60 to 100 beats per minute for adults.