If a patient diagnosed with hypertension is prescribed Propranolol (Inderal), what patient history should prompt the nurse to consult with the healthcare provider before administering this drug?

Choice A rationale
Education on the necessity of continuous antibiotic prophylaxis is crucial for patients who have just recovered from rheumatic fever. Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or inadequately treated strep throat or scarlet fever.
Patients who have had rheumatic fever are at risk of getting it again if they have another strep infection. Continuous antibiotic prophylaxis can prevent recurrent infections and the development of rheumatic heart disease.
Choice B rationale
While anticoagulation therapy may be necessary for some patients with heart conditions, it is not typically the most important nursing action for a patient who has just recovered from rheumatic fever. Rheumatic fever can cause inflammation and damage to the heart valves, but it does not typically cause blood clots, which are the primary reason for anticoagulation therapy.
Choice C rationale
Adherence to standard infection control procedures is important for all patients, but it is not the most important nursing action for a patient who has just recovered from rheumatic fever. The primary concern for these patients is preventing recurrent strep infections, which can be achieved through continuous antibiotic prophylaxis.
Choice D rationale
While physical activity management may be part of the overall care plan for a patient who has just recovered from rheumatic fever, it is not typically the most important nursing action. The primary concern for these patients is preventing recurrent strep infections, which can be achieved through continuous antibiotic prophylaxis.

Choice A rationale
Digoxin slows the heart rate and increases the force of heart contractions, which can be beneficial in heart failure. However, if the pulse is below 60 beats/min, taking digoxin could further slow the heart rate and potentially lead to bradycardia.
Choice B rationale
Nausea can be a side effect of digoxin and hydrochlorothiazide. If the patient develops nausea, they should notify their healthcare provider as this could indicate that the medication dose needs adjustment.
Choice C rationale
Hydrochlorothiazide can cause the body to lose potassium, so limiting dietary intake of potassium could potentially lead to hypokalemia, a condition characterized by low potassium levels in the blood.
Choice D rationale
Taking hydrochlorothiazide at bedtime could potentially lead to nocturia, which is the need to wake up at night to urinate. This could disrupt the patient’s sleep.