A client has recently begun medication therapy with propranolol (Inderal). The long-term care nurse should plan to notify the physician if which of the following assessment findings is noted?

Question

1. Complaints of insomnia
2. Audible expiratory wheezes
3. Decrease in heart rate from 86 to 78 beats/min
4. Decrease in blood pressure from 162/90 to 136/84 mm Hg

Answer 1

2

Rationale: Propranolol (Inderal) is a beta-blocker. Audible expiratory wheezes could indicate bronchospasm, a serious adverse reaction. Beta blockers that are not cardioselective, such as propranolol, may induce this reaction, particularly in clients with chronic obstructive pulmonary disease (COPD) or asthma. A normal decrease in blood pressure and heart rate is expected. Insomnia is a frequent mild side effect and should continue to be monitored.