Which of the following items should the nurse include in teaching Sara about asthma? (Select all that apply)

Choice A reason: Daily alcohol use may amplify propranolol’s CNS depression, but it’s not a contraindication. It warrants monitoring for sedation, yet hypertension treatment proceeds, as no direct physiologic conflict exists with beta-blockade.

Choice B reason: Asthma contraindicates propranolol, a non-selective beta-blocker, as it blocks β2 receptors, causing bronchoconstriction. This risks severe airway obstruction in asthmatics, prompting consultation for a cardioselective alternative like atenolol.

Choice C reason: Peptic ulcer disease isn’t affected by propranolol directly; beta-blockers don’t alter gastric acid. It’s not a contraindication, though stress-related hypertension management might consider other factors, not this drug.

Choice D reason: Post-MI, propranolol reduces myocardial demand, aiding recovery. It’s beneficial, not contraindicated, lowering reinfarction risk via β1 blockade, so no consultation is needed unless acute decompensation occurs.

Choice A reason: Staying indoors may limit exposure but isn’t practical or evidence-based for pneumonia prevention. It’s less effective than vaccines or hygiene, as pathogens persist indoors, reducing its priority in teaching.

Choice B reason: Yearly flu vaccine prevents influenza, a pneumonia risk factor, by inducing immunity. It’s a cornerstone of prevention, reducing respiratory infections that predispose to bacterial pneumonia, per public health guidelines.

Choice C reason: Regular exercise and nutrition boost immunity, reducing pneumonia risk. Strong lungs and host defenses limit infection severity, making this a key lifestyle topic for long-term respiratory health protection.

Choice D reason: Using a fan circulates air but doesn’t prevent pneumonia pathogens effectively. It may dry mucosa, increasing susceptibility, so it’s not a standard recommendation compared to vaccines or hygiene.

Choice E reason: Staying away from crowds reduces exposure to respiratory pathogens causing pneumonia. It’s practical during outbreaks, complementing vaccines and hygiene as a behavioral strategy to lower infection risk.

Choice F reason: Handwashing removes pathogens, preventing pneumonia transmission via contact. It’s a simple, evidence-based habit, critical in breaking infection chains, making it essential in patient education for prevention.

Choice G reason: Pneumonia vaccine (e.g., PCV13, PPSV23) protects against Streptococcus pneumoniae, a top cause. It’s a primary prevention tool, reducing incidence, strongly recommended for at-risk patients in teaching plans.