Please clarify...

[Sharmi RN-BSN, BSN]

Can anyone please tell me the answer and the reason behind choosing??

The nurse should question the order if propanolol (Inderal) is ordered for which of

the following patients?

1. A 39-year-old woman with type 1 diabetes.

2. A 45-year-old woman with peptic ulcer disease.

3.A 49-year-old man with a history of bronchial

asthma.

4. A 60-year-old man with atrial tachycardia.

I know propanolol (Inderal) are contraindicated in diabetic and asthmatic patient.But which one should i choose in this kind of question and why??

[bayou]

I would like to choose # 4. I use elimination to do it.

propanolol (Inderal) contraindications:

1, Bradydysrhythemias, atrioventricular(AV) block.

2, Chronic respiratory problems.

3, Diabetes.

4, HF.

5, Hepatic and renal dysfunction.

So, eliminate #1,#3

propanolol (Inderal) side effects:

1, Bradycardia.

2, Lethargy.

3, GI disturbance.

4, CHF

5, BP decrease

6, Depression

So, eliminate #2

I don't know if my answer is correct.

[nursej22, MSN, RN]

I won't tell you the answer, but my general rule of thumb on these sorts of questions is what will kill you first or fastest? To Bayou, I think you may have misread the question.

[Sharmi RN-BSN, BSN]

I won't tell you the answer, but my general rule of thumb on these sorts of questions is what will kill you first or fastest? To Bayou, I think you may have misread the question.

Okay i got it.So the correct answer is number 3.

[bayou]

Nursej22

Could you please explain this question? to clarify my understanding.

[bayou]

AspiringRN2b Could you explain it to me? Thanks,

[PRNketamine7, BSN, RN]

Even if you weren't completely sure of when this med us contraindicated you can used elimination. GI is out, since it's not the most important thing, diabetes is out for the same reason (can correct a metabolic problem). Then your left with airway and circulation. So used ABC. So the asthma would be the answer

[bayou]

Thanks for your explanation. I have misread the question. I understand now.

[ships]

As per Saunders book if the patient having asthma with angina pectoris than praponol is contraindicated.

[nursej22, MSN, RN]

On medication types of questions, consider the action and therefore the effect of the drug. In this case, propanolol blocks the effects of adrenaline and so it blocks that "fight or flight" response. What happens when your adrenaline kicks in? Your heart races, your eyes dilate, your blood sugar rises and you are ready to run from that sabre-tooth tiger. So propanolol will slow tachycardia and decrease nervousness.

Some of the drug effect is undesirable though. Some adrenaline receptors are in the bronchioles and blocking them can trigger bronchospasm, a dangerous and potentially fatal consequence. Note, newer types of beta-blockers are more selective in which receptors they block so may actually be used cautiously where once they were contraindicated.

Looking back at your choices:

A. diabetes, Inderal not ideal but can be countered which insulin adjustment.

B. peptic ulcer disease, again can be countered by advising to take with food.

C. Asthma, Inderal potentially fatal

D. Tachycardia, Inderal would actually be therapeutic and indicated.