NCLEX-PN® ExaminationPharmacological TherapiesHard
A client with a history of asthma is prescribed propranolol, a non-selective beta-blocker, for hypertension. The LPN reviews the client's medical history. Which finding should the LPN prioritize when questioning the appropriateness of this medication?
- AOccasional heartburn.
- BHistory of seasonal allergies.
- CDiagnosis of chronic obstructive pulmonary disease (COPD).
- DFamily history of diabetes mellitus.
Show answer & explanationAnswer & explanation
Correct answer: C. Diagnosis of chronic obstructive pulmonary disease (COPD).
Non-selective beta-blockers like propranolol are contraindicated in clients with respiratory diseases such as asthma or COPD because they can cause bronchoconstriction by blocking beta-2 receptors in the lungs, potentially leading to severe respiratory distress.
Why the other options are wrong
- A. Occasional heartburn is typically manageable and not a contraindication for propranolol.
- B. Seasonal allergies are generally not a contraindication for propranolol.
- D. While beta-blockers can mask symptoms of hypoglycemia, a family history of diabetes is not a direct contraindication for propranolol in the same critical way as a respiratory disease.
Non-selective Beta-Blockers & Respiratory Disease
Non-selective beta-blockers, such as propranolol, are contraindicated in clients with asthma or COPD due to their potential to induce bronchoconstriction by blocking beta-2 adrenergic receptors in the lungs.
- Propranolol is non-selective.
- Blocks beta-1 (heart) and beta-2 (lungs) receptors.
- Beta-2 blockade causes bronchoconstriction.
- Dangerous for clients with asthma/COPD.
Memory trick: PROPRANOLOL: Pulmonary Risk, Obstructive Respiratory