A nurse is caring for a client who is taking lisinopril.
Which of the following outcomes indicates a therapeutic effect of the medication?

This question focuses on contraindications for non-selective beta-blocker therapy. It requires understanding the physiological effect of blocking beta-2 receptors, which leads to bronchoconstriction, posing a significant, life-threatening risk for patients with underlying obstructive airway diseases, necessitating careful assessment prior to administration.

Choice A rationale

Hypertension is a primary therapeutic indication for propranolol. The medication effectively lowers blood pressure by reducing cardiac output and inhibiting renin release from the kidneys, making it a highly indicated and beneficial medication for patients suffering from hypertensive conditions.

Choice B rationale

Propranolol is a non-selective beta-blocker that antagonizes both beta-1 and beta-2 receptors. Beta-2 receptor blockade induces bronchial smooth muscle constriction, which can precipitate a severe, life-threatening bronchospasm in patients with asthma, making it a strict contraindication for this patient population.

Choice C rationale

Tachycardia is a valid indication for propranolol. By blocking beta-1 receptors in the heart, the medication slows the heart rate and decreases myocardial oxygen demand, providing therapeutic relief for patients experiencing tachyarrhythmias or excessive cardiac workload due to heart-related issues.

Choice D rationale

Angina is a standard indication for propranolol. By reducing the heart rate and the force of contraction, the medication decreases the oxygen requirements of the myocardium, which helps to alleviate chest pain and improve the overall exercise tolerance of the cardiac patient.

This question focuses on dietary management for patients taking antithyroid medications, such as methimazole or propylthiouracil. It requires understanding the relationship between iodine intake and thyroid hormone synthesis, and how diet can influence the therapeutic efficacy of medications aimed at reducing thyroid activity.

Choice A rationale

There is no standard clinical requirement to restrict fluid intake to 2500 mL per day for patients on antithyroid therapy. Fluid management should be individualized based on the patient's clinical status, not as a general instruction for this drug class.

Choice B rationale

Antithyroid drugs work by inhibiting the incorporation of iodine into tyrosine residues. Consuming high-iodine foods can counteract the therapeutic effect of these medications. Therefore, patients are instructed to avoid iodized salt, seaweed, and other foods rich in iodine.

Choice C rationale

Increasing sodium and potassium intake is not a standard requirement for patients on antithyroid therapy. Dietary sodium and potassium balance should be maintained within normal limits unless the patient has a specific clinical condition requiring modification of these electrolytes.

Choice D rationale

Iodized salt is a significant source of dietary iodine. Using it while taking antithyroid medication interferes with the drug's mechanism of action, which is designed to block iodine utilization, thereby reducing the overall effectiveness of the treatment for the patient.