The nurse has provided information to a patient with diabetes who has been prescribed a non-selective beta-adrenergic blocker. Which statement is correct?
I may have low blood sugars.
My dosage may need adjustment if I start taking any NSAIDs.
I will need to be evaluated in a few weeks to see if my dosage is effective.
If I get dizzy, I will stop taking the medication.
The Correct Answer is A
Choice A reason: This is the correct statement. Non-selective beta-adrenergic blockers can interfere with the signs and symptoms of hypoglycemia (low blood sugar), such as tachycardia, tremors, and sweating. They can also impair the glucose metabolism and insulin secretion in the body. Therefore, patients with diabetes who take non-selective beta-adrenergic blockers need to monitor their blood glucose levels closely and adjust their insulin or oral hypoglycemic agents accordingly.
Choice B reason: This is not a correct statement. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, do not interact with non-selective beta-adrenergic blockers. However, they can reduce the effectiveness of other antihypertensive medications, such as diuretics or ACE inhibitors, by causing fluid retention and decreasing renal blood flow.
Choice C reason: This is not a correct statement. Non-selective beta-adrenergic blockers have a rapid onset of action and can lower the blood pressure within hours of administration. Therefore, patients do not need to wait for a few weeks to see if their dosage is effective. However, they may need periodic follow-up visits to monitor their blood pressure, heart rate, and other vital signs.
Choice D reason: This is not a correct statement. Dizziness is a common side effect of non-selective beta-adrenergic 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 does not mean that the patient should stop taking the medication, as this can cause rebound hypertension and other complications. Instead, the patient should rise slowly from a sitting or lying position, drink plenty of fluids, and report any severe or persistent dizziness to their health care provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the correct mechanism of action of propranolol. Propranolol is a beta blocker medication, which means that it blocks the beta receptors in the heart and blood vessels. This reduces the sympathetic stimulation in cardiac muscle, which lowers the heart rate, contractility, and oxygen demand. This also reduces the renin release from the kidneys, which lowers the blood pressure.
Choice B reason: This is not the mechanism of action of propranolol. Propranolol does not increase the diuretic response in the renal tubules. This is the effect of diuretic medications, such as furosemide or hydrochlorothiazide, which increase the urine output and decrease the blood volume and pressure.
Choice C reason: This is not the mechanism of action of propranolol. Propranolol does not inhibit the conversion of angiotensin I to angiotensin II. This is the effect of angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril or enalapril, which block the formation of angiotensin II, a potent vasoconstrictor that raises the blood pressure.
Choice D reason: This is not the mechanism of action of propranolol. Propranolol does not block alpha receptors throughout the body. This is the effect of alpha blockers, such as doxazosin or prazosin, which block the alpha receptors in the blood vessels and cause vasodilation, which lowers the blood pressure.
Correct Answer is D
Explanation
Choice A reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Hyperglycemia is a high level of glucose in the blood, which can be caused by diabetes or other conditions. Nonselective beta-adrenergic blockers do not affect blood glucose levels directly, but they may mask the signs of hypoglycemia (low blood glucose) in diabetic patients.
Choice B reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Dizziness is a common side effect of many medications, especially those that lower blood pressure. Nonselective beta-adrenergic blockers can cause dizziness by reducing the heart rate and cardiac output, but this is usually mild and transient.
Choice C reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Peripheral edema is swelling of the ankles, feet, or legs, which can be caused by heart failure, kidney disease, or venous insufficiency. Nonselective beta-adrenergic blockers do not cause peripheral edema, but they may worsen it in patients with heart failure.
Choice D reason: This is a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Wheezing is a high-pitched sound that occurs when breathing is obstructed, usually due to asthma or chronic obstructive pulmonary disease (COPD). Nonselective beta-adrenergic blockers can aggravate or cause wheezing by blocking the beta-2 receptors in the lungs, which normally cause bronchodilation (widening of the airways). Therefore, nonselective beta-adrenergic blockers are contraindicated in patients with asthma or COPD.
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