The prescriber orders propranolol (Inderal) for a patient with a blood pressure reading of 200/106 . An electrocardiogram taken shortly afterward shows an atrioventricular (AV) block
The nurse should immediately hold the propranolol and report this finding to the prescriber for which rea-son? a. Lowering the blood pressure will require at least two different drugs.
b. Beta blockers can intensify an AV block.
c. Some reflex tachycardia may be associated with this agent.
d. The drug may cause a cough, which might further disrupt the cardiac rhythm.
B
Beta blockers cause blockade of cardiac beta1 receptors, which can result in reduced atrioventri-cular conduction.
Two different medications are not generally needed to improve a hypertensive crisis.
The dilemma is the hypertensive crisis, which may lead to AV block, not the reflex tachycardia.
Cough is not a side effect of this beta blocker and does not contribute to a cardiac dysrhythmia; this would be the least concern of the scenario.
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