Propranolol (Inderal) is newly prescribed for a patient diagnosed with hypertension. Which information in the patient’s history would prompt the nurse to consult with the health care provider before giving this drug?

Choice A reason: Pneumonia causes cough, chest pain, and dyspnea, not facial pain or nasal drainage primarily. Fever fits, but symptom location (lungs vs. sinuses) rules it out for these presenting complaints.

Choice B reason: Acute sinusitis matches pain over nose/eyes/forehead, purulent drainage, fever, and malaise. Bacterial or viral inflammation of sinuses causes these classic signs, aligning perfectly with the patient’s symptoms.

Choice C reason: Tuberculosis involves chronic cough, weight loss, and night sweats, not acute facial pain or drainage. It’s a lung infection, lacking sinus-specific symptoms, making it an unlikely diagnosis here.

Choice D reason: Pharyngitis causes throat pain, not sinus-area pain or nasal drainage. Fever and malaise fit, but the location and purulence point to sinusitis, not a pharyngeal infection, in this case.

Choice A reason: Ceftriaxone treats infection, but giving it before cultures risks sterilizing samples, skewing results. It’s critical therapy, yet obtaining accurate diagnostics first ensures targeted treatment, delaying antibiotics briefly.

Choice B reason: Antipyretics reduce fever, a symptom, not the cause. Cultures take priority to identify pathogens before comfort measures, as fever management doesn’t alter diagnostic or treatment urgency in this case.

Choice C reason: Blood and sputum cultures identify the causative organism in suspected infection (e.g., pneumonia). They must be obtained first, before antibiotics, to ensure accuracy, guiding effective therapy and avoiding false negatives.

Choice D reason: Monitoring glucose is routine, not urgent in acute infection unless diabetic crisis is suspected. Cultures precede this, as identifying the pathogen drives treatment, while glucose can wait without immediate risk.

Choice E reason: Monitoring intake and output tracks fluid status, useful but secondary in acute infection. Cultures are the priority to diagnose and treat effectively, as I&O doesn’t alter initial management decisions.