A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension.
The nurse should recognize which of the following conditions is a contraindication for taking propranolol?

Furosemide is a diuretic that lowers blood pressure and increases urine output. It also causes potassium loss, which can lead to hypokalemia (low potassium levels). The patient’s blood pressure is already low when sitting, and the serum potassium is below the normal range of 3.5 to 5.0 mEq/L. Administering furosemide could worsen these conditions and cause adverse effects such as dehydration, dizziness, muscle weakness, cardiac arrhythmias, and renal impairment. Therefore, the nurse should contact the provider before giving the medication and report the vital signs and laboratory results.

Choice A. Administer medication is wrong because it could harm the patient as explained above.

Choice C. Hold medication until next dose is wrong because it does not address the underlying problem of fluid retention and hypokalemia.

The nurse should not delay notifying the provider about the patient’s condition.

Choice D. Check urine output before giving medication is wrong because it is not enough to ensure the patient’s safety.

The nurse should also check the blood pressure and serum potassium levels, which are more critical indicators of the patient’s status.

Anticoagulant drugs are medicines that prevent blood clots from forming or growing larger.

They do not dissolve existing clots or transport platelets. They work by interfering with different steps of the blood coagulation pathway, which is the process that leads to clot formation.

Choice A is wrong because anticoagulant drugs do not dissolve existing clots.

To dissolve clots, you need fibrinolytic drugs, which break down the fibrin mesh that holds the clots together.

Choice B is wrong because anticoagulant drugs do not transport platelets.

Platelets are blood cells that stick together to form clots.

Anticoagulant drugs may affect the function of platelets, but they do not move them around.

Choice C is wrong because anticoagulant drugs do not act as fibrinolytic agents.

Fibrinolytic agents are drugs that activate plasmin, an enzyme that breaks down fibrin.

Anticoagulant drugs may inhibit the formation of fibrin, but they do not break it down.

Some examples of anticoagulant drugs are warfarin, heparin, and factor Xa inhibitors.

The normal ranges for some blood tests that measure the effects of anticoagulants are:

• Prothrombin time (PT): 11 to 13.5 seconds

• International normalized ratio (INR): 0.8 to 1.2

• Activated partial thromboplastin time (aPTT): 25 to 35 seconds