NCLEX-PN® ExaminationPharmacological TherapiesMedium
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed a new medication. The LPN notes the medication is propranolol, a non-selective beta-blocker. What is the LPN's primary concern regarding this medication for this client?
- ADevelopment of orthostatic hypotension.
- BIncreased risk of bleeding.
- CExacerbation of bronchospasm.
- DRisk of hyperglycemia.
Show answer & explanationAnswer & explanation
Correct answer: C. Exacerbation of bronchospasm.
Non-selective beta-blockers like propranolol block both beta-1 and beta-2 adrenergic receptors. Blocking beta-2 receptors in the lungs can lead to bronchoconstriction, which is dangerous for clients with respiratory conditions like COPD or asthma, potentially causing severe bronchospasm.
Why the other options are wrong
- A. Orthostatic hypotension is a common side effect of many antihypertensive medications, including beta-blockers, but bronchospasm is a more direct and severe concern for a client with COPD.
- B. Beta-blockers do not directly increase the risk of bleeding; this is more associated with anticoagulants or antiplatelet drugs.
- D. Beta-blockers can mask symptoms of hypoglycemia and rarely cause hyperglycemia, but this is not the primary concern for a COPD client.
Non-Selective Beta-Blockers & Respiratory Disease
Non-selective beta-blockers block beta-2 receptors in the lungs, which can cause bronchoconstriction and worsen respiratory conditions like asthma or COPD.
- Propranolol is non-selective.
- Contraindicated/cautioned in COPD/asthma.
- Causes bronchoconstriction.
Memory trick: Non-Selective = Nasty Lungs; Selective = Safer Heart!