A patient will begin taking propranolol [Inderal] for hypertension. Which statement by the nurse is important when teaching this patient about the medication?
a. "Check your hands and feet for swelling and report that to your provider."
b. "It is safe to take this medication with a calcium channel blocker."
c. "Stop taking the drug if you become short of breath."
d. "Take your pulse and do not take the me-dication if your heart rate is fast."
A
Patients taking propranolol can develop heart failure because of the suppression in myocardial contractility. Patients should be taught to watch for signs, which include shortness of breath, night coughs, and swelling of the extremities. Use of these agents with calcium channel blockers is contraindicated, because the effects are identical and excessive cardiosuppression can occur. Shortness of breath should be reported to the provider, but abrupt cessation of the drug can cause rebound cardiac excitability. Propranolol reduces the heart rate and should not be given if the pulse is less than 60 beats per minute.
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