Question

You are working as a nurse on the cardiac unit. Mr. D was recently prescribed propranolol (Inderal). You prepare his medications and start the discharge teaching plan.

1.           Your patient asks what the side effects of propranolol are. How would you respond?

Answer:

2.           What nursing interventions should be implemented prior to medication administration?

Answer:

3.           Your patient asks why he cannot stop the medication. How would you advise this patient?

Answer:

Answer 1

Propanolol is a non selective beta blocker mainly used to treat hypertension, cardiac arhythmia and heart failure. It reduce force of contraction of heart and there by reduce the heart rate and blood.

1. Propanolol has effects on heart and circulation. The side effects may include

• Irregular heart beats
• Slow heart rates
• Difficulty in breathing
• Weight gain
• Visions problems
• Cool extremities
• Fatigue and weakness
• Low blood sugar levels
• Hypersensitivity reaction
• Nausea, vomiting, stomach problems, fatigue, and insomnia

2. Nursing interventions prior to the administration of inderal.

1 )Propanolol is contraindicated in patients with allergies to the medication, sinus bradycardia, compensated cardiac failure, severe peripheral arterial diseases, heart block, and asthma and other pulmonary Conditions.Thus the nurse must obtain a detailed history before administration of the medication for any of these conditions.

2) Blood pressure and heart rate to be monitored before administration of Propanolol.

3) Administer the drug along with food to improve absorption,if administrated orally.

4) Obtain electrocardiogram, check peripheral perfusion, blood glucose level,

5) Patient teaching regarding the action and side effects of medication.

6) Teach the patient not to stop the medication suddenly which may cause fatal effects.

7) Advise the patient not to take more than prescribed dose even if one dose is missed. If the dose is missed take it when remember or avoid the dose if the next dose is in less than 8 hours.( For inderal as it is extended release tablet, if regular Propanolol it will be 4 hours as it is short acting)

8) Advise the patient not to crush, chew, break the medication while taking it.

9) Advise the patient to report any side effects as soon as development.

3. Sudden stop of medication can worsen chest pain, increase blood pressure, cause cardiac dysrhythmias, or even can cause heart attack. So the medication should not be stopped abruptly. The physician will gradually taper and stop the medication as needed.