What health teaching should the nurse provide for the client receiving nadolol (Corgard)?

Many antihypertensive drugs, such as beta blockers and certain diuretics, can cause sexual dysfunction, including decreased libido, erectile dysfunction, or difficulty with ejaculation. These effects can significantly impact adherence to therapy. The most appropriate nursing action is to acknowledge the concern and inform the patient that the physician can adjust the dose or change the medication to minimize side effects while maintaining blood pressure control.

Rationale for correct answer:

B. “The physician can work with you on changing the dose and/or drugs.”
This response shows therapeutic communication and supports collaboration in care. The nurse recognizes that sexual dysfunction is a common adverse effect of some antihypertensives and encourages the patient to discuss it with the provider. Adjusting the dose, changing to a different class (e.g., ACE inhibitor, ARB, or calcium channel blocker), or timing the medication differently can often resolve the issue.

Rationales for incorrect answers:

A. “Not to worry. Eventually, tolerance will develop.”
This statement is inaccurate and dismissive. Tolerance to sexual side effects does not typically occur with antihypertensive therapy, and reassurance without intervention may discourage further communication about the issue.

C. “Sexual dysfunction happens with this therapy, and you will learn to accept it.”
This response is non-therapeutic and lacks empathy. It dismisses the patient’s concern and may lead to nonadherence, as sexual health is an important aspect of quality of life.

D. “This is an unusual occurrence, but it is important to stay on your medications.”
This response provides false reassurance, as sexual dysfunction is actually a common side effect of many antihypertensive drugs. It also ignores the opportunity to address the patient’s concern through collaborative problem-solving.

Take-home points:
• Sexual dysfunction is a common side effect of beta blockers and diuretics used for hypertension.
• The nurse should encourage open communication and refer the patient for possible medication adjustment.
• Empathetic, therapeutic responses improve adherence and patient satisfaction with treatment.

For clients with hypertension, lifestyle modifications remain essential even after starting on medication therapy. Pharmacologic treatment is often necessary when lifestyle measures alone are insufficient, but it does not replace them. Combining drug therapy with lifestyle changes such as diet modification, weight control, physical activity, and smoking cessation provides the best long-term control of blood pressure and prevention of complications such as stroke, myocardial infarction, and renal damage.

Rationale for correct answer:

A. “I figure that since I have started on these medications that I don’t have to follow those lifestyle modifications anymore.”
This statement demonstrates a misunderstanding of hypertension management. Antihypertensive drugs work best when combined with ongoing lifestyle modifications, including reduced sodium intake, regular exercise, limited alcohol consumption, and stress management. Discontinuing these habits can lead to poor blood pressure control and increased risk of cardiovascular complications despite medication adherence. The nurse should reinforce that lifestyle changes are a lifelong commitment, not a temporary measure.

Rationales for incorrect answers:

B. “I will walk every day at least 20 minutes.”
This reflects positive adherence to exercise recommendations. Regular physical activity, such as brisk walking for 20–30 minutes most days of the week, improves cardiovascular function and helps reduce blood pressure.

C. “I will weigh myself at the same time every day and report a weight gain of more than 2 pounds.”
Daily weight monitoring helps detect fluid retention, especially in clients taking diuretics or those with cardiovascular comorbidities. This is an appropriate and safe self-care behavior.

D. “I think that I can keep track of my blood pressure using a journal to record it.”
Keeping a blood pressure log demonstrates active self-monitoring, which allows both the patient and provider to evaluate treatment effectiveness and make necessary adjustments. This behavior supports effective long-term hypertension management.

Take-home points:
• Lifestyle modifications must continue even after antihypertensive therapy begins.
• Medication and healthy habits work synergistically to maintain optimal blood pressure control.
• Patient education should emphasize that long-term adherence to both pharmacologic and lifestyle measures prevents complications and promotes cardiovascular health.