Beta-Adrenergic Blockers

Every question here, with the answer

1. Before giving a scheduled dose of atenolol, the nurse finds a heart rate of 54 beats per minute and a blood pressure of 118/76 mm Hg. What should the nurse do?

   1. Give the dose as scheduled.
   2. Give the dose with a glass of water to speed absorption.
   3. Give the dose and recheck the pulse in four hours.
   4. Hold the dose and notify the health care provider.

   Answer: Hold the dose and notify the health care provider.

   The nurse does not give a beta blocker when the heart rate is less than 60 beats per minute and notifies the provider. Giving the dose in any form would slow an already slow heart further.

2. A client with asthma uses an albuterol inhaler as needed. The provider is considering a beta blocker for hypertension. Why should the nurse raise this with the provider?

   1. Albuterol must be stopped before any beta blocker is started.
   2. Beta blockers make albuterol work too strongly.
   3. Beta blockers can reduce the effectiveness of short-acting beta agonists.
   4. Beta blockers cure the client's asthma.

   Answer: Beta blockers can reduce the effectiveness of short-acting beta agonists.

   The nurse must assess whether clients take short-acting beta agonists because beta blockers can reduce their effectiveness, and beta 2 inhibition can decrease lung function. The other options are not supported by the section.

3. A client with type 1 diabetes has just started metoprolol. What should the nurse teach about low blood sugar?

   1. You no longer need to check your glucose.
   2. Metoprolol prevents low blood sugar.
   3. Stop metoprolol if your glucose is low.
   4. Your usual symptoms of low blood sugar may be masked, so check your glucose closely.

   Answer: Your usual symptoms of low blood sugar may be masked, so check your glucose closely.

   Beta blockers can mask the symptoms of hypoglycemia in clients with diabetes, so glucose must be monitored closely. They do not prevent hypoglycemia, and stopping the drug without the provider is unsafe.

4. A client taking propranolol says, "I feel fine now, so I'm going to stop my pills this weekend." What is the nurse's best response?

   1. That is fine once your blood pressure is normal.
   2. Stop every other dose first, then stop completely.
   3. Switch to an herbal supplement instead.
   4. Do not stop suddenly; talk with your provider, because stopping abruptly can worsen angina or cause a heart attack.

   Answer: Do not stop suddenly; talk with your provider, because stopping abruptly can worsen angina or cause a heart attack.

   The black box warning says beta blocker therapy should not be stopped abruptly but tapered gradually to avoid exacerbation of angina and myocardial infarction, and clients should seek the provider's advice first. A self-made taper or herbal substitute is not safe.

5. A nurse is teaching a client who is going home on a beta-adrenergic blocker. Which instructions should the nurse include? Select all that apply.

   1. Ask your provider before taking herbal supplements such as ephedra or licorice.
   2. Report weight gain and swelling in your legs.
   3. Take the medication only when your heart feels fast.
   4. Check your pulse before taking the medication.
   5. Do not crush extended-release tablets.

   Answer: Ask your provider before taking herbal supplements such as ephedra or licorice., Report weight gain and swelling in your legs., Check your pulse before taking the medication., Do not crush extended-release tablets.

   Clients check their pulse before each dose, do not crush extended-release forms, report signs of worsening heart failure such as weight gain and peripheral edema, and consult the provider before herbal supplements. Taking the drug only when the heart feels fast is intermittent use, which is unsafe.

6. Which serious adverse effects should the nurse monitor for in a client taking a beta blocker? Select all that apply.

   1. Hypotension
   2. Hypoglycemia
   3. Bradycardia
   4. Hypertension
   5. Hyperkalemia

   Answer: Hypotension, Hypoglycemia, Bradycardia

   The serious adverse effects of beta blockers listed in the section are bradycardia, arrhythmias, hypoglycemia, and hypotension. Beta blockers lower blood pressure rather than raise it, and hyperkalemia is not listed for beta blockers here.