Question

An aging client with chronic schizophrenia takes a beta-adrenergic blocking agent (propranolol) for his hypertension and an antipsychotic. Given the combined side effects of these drugs, which client teaching is most important?

A.) "Make sure you concentrate on taking slow, deep, cleansing breaths."
B.) "Watch your diet and try to engage in some regular physical activity."
C.) "Rise slowly when you change positions from lying or sitting to standing."
D.) "Wear sunscreen and try to avoid midday sun exposure."

Answer 1

The most important teaching for a client taking propranolol and antipsychotics is to rise slowly from lying or sitting to standing to avoid orthostatic hypotension. Both types of medication can contribute to lowering blood pressure upon position changes, increasing the risk of falls.

Step-by-step explanation:

Given the combined side effects of beta-adrenergic blocking agents like propranolol and antipsychotics, the most important client teaching for an aging client with chronic schizophrenia and hypertension would be "Rise slowly when you change positions from lying or sitting to standing." Beta-blockers can cause a decrease in blood pressure upon suddenly changing positions, a phenomenon known as orthostatic hypotension. In addition, antipsychotics may also contribute to this risk. It is vital for the client to be aware of this to prevent dizziness and potential falls, which can be dangerous, especially in the elderly.

Both beta-blockers and antipsychotics can cause a variety of side effects, including but not limited to bradycardia (slowed heart rate), sedation, and decreased initiative. Propranolol, in particular, has a hypotensive effect by blocking beta-receptors that are associated with vasoconstriction and increasing the heart rate. Therefore, the patient should be advised to adopt a cautious approach when changing from a prone or seated position to an upright one to prevent symptoms of hypotension and maintain their safety.