A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following medications for this client?

Choice A reason: The client has a history of hypertension is not the correct answer. Hypertension is a condition in which the blood pressure is abnormally high, usually above 140/90 mmHg. Propranolol is a beta-blocker that lowers the blood pressure and reduces the workload of the heart. Propranolol is indicated for the treatment of hypertension and angina pectoris, which is a type of chest pain caused by reduced blood flow to the heart. The nurse does not need to report this finding to the provider, as it is consistent with the prescription.

Choice B reason: The client has a history of hypothyroidism is not the correct answer. Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels. Propranolol can mask some of the signs of hypothyroidism, such as tachycardia, tremors, and anxiety. Propranolol can also interfere with the absorption and conversion of thyroid hormones. The nurse should monitor the client's thyroid function tests and report any abnormal values to the provider, but this finding is not a contraindication to the use of propranolol.

Choice C reason: The client has a history of bronchial asthma is the correct answer. Bronchial asthma is a chronic inflammatory disorder of the airways that causes wheezing, coughing, and shortness of breath. Propranolol is a non-selective beta-blocker that blocks the beta-1 receptors in the heart and the beta-2 receptors in the lungs. Blocking the beta-2 receptors can cause bronchoconstriction, which can worsen the symptoms of asthma and trigger an asthma attack. Propranolol is contraindicated in clients who have bronchial asthma, and the nurse should report this finding to the provider immediately.

Choice D reason: The client has a history of migraine headaches is not the correct answer. Migraine headaches are recurrent episodes of severe and throbbing pain, usually on one side of the head, that can be accompanied by nausea, vomiting, and sensitivity to light and sound. Propranolol is effective in preventing migraine headaches, as it reduces the frequency and severity of the attacks. Propranolol is indicated for the prophylaxis of migraine headaches, and the nurse does not need to report this finding to the provider, as it is consistent with the prescription.

Choice A reason: This is incorrect because dextrose 5% in 0.45% sodium chloride is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.

Choice B reason: This is correct because 0.9% sodium chloride is a isotonic solution that is compatible with blood products. It does not cause hemolysis or fluid shifts and maintains the osmotic pressure of the blood.

Choice C reason: This is incorrect because lactated Ringer's solution is a isotonic solution that contains electrolytes, such as potassium, calcium, and lactate, that can interfere with the blood products. It can also cause metabolic alkalosis due to the conversion of lactate to bicarbonate.

Choice D reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.