How does propranolol (Inderal), a beta blocker medication, control hypertension?

Choice A reason: The patient should not use the glucocorticoid as needed when symptoms flare. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, not as a rescue medication.

Choice B reason: The patient does not need to use the beta2-adrenergic agonist drug daily even when they don't have any symptoms. The beta2-adrenergic agonist is a short-acting bronchodilator that relaxes the smooth muscles of the airways and improves airflow. It should be used as needed for relief of acute symptoms, not as a maintenance medication.

Choice C reason: The beta2-adrenergic agonist does not suppress the synthesis of inflammatory mediators. The beta2-adrenergic agonist is a bronchodilator that acts on the beta2 receptors of the airways and causes relaxation of the smooth muscles. It does not have any anti-inflammatory effects.

Choice D reason: The glucocorticoid is used as prophylaxis to prevent exacerbations every day. This is the correct statement that indicates understanding of this medication regimen. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, along with the beta2-adrenergic agonist as needed for relief of acute symptoms.

Choice A reason: This is not the action that the nurse should take. Instructing the patient to monitor weight daily is not relevant to the patient's dizziness. Weight monitoring is more useful for patients with fluid retention or heart failure, which are not caused by calcium channel blockers.

Choice B reason: This is not the action that the nurse should take. Informing the patient to discontinue the medication is not appropriate, as this can cause rebound hypertension and other complications. The patient should not stop taking the medication without consulting their health care provider.

Choice C reason: This is not the action that the nurse should take. Advising the patient to increase dietary sodium is not helpful, as this can worsen the hypertension and increase the risk of cardiovascular events. The patient should follow a low-sodium diet and avoid salt substitutes that contain potassium.

Choice D reason: This is the action that the nurse should take. Encouraging the patient to sit down if feeling faint is a simple and effective way to prevent falls and injuries. Dizziness is a common side effect of calcium channel blockers, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this side effect is usually mild and transient, and can be prevented by rising slowly from a sitting or lying position, drinking plenty of fluids, and avoiding alcohol.