Page 1784 - Saunders Comprehensive Review For NCLEX-RN

B. Side and adverse effects

1. Bradycardia
2. Bronchospasm
3. Hypotension
4. Weakness, fatigue
5. Nausea, vomiting
6. Dizziness
7. Hyperglycemia
8. Agranulocytosis
9. Behavioral or psychotic response
10. Depression
11. Nightmares
C. Interventions

1. Monitor vital signs.
2. Withhold the medication if the pulse or BP is not
within the prescribed parameters.
3. Monitor for signs of heart failure or worsening heart
failure.
4. Assess for respiratory distress and for signs of
wheezing and dyspnea.
5. Instruct the client to report dizziness, lightheadedness,
or nasal congestion.
6. Instruct the client not to stop the medication, because
rebound hypertension, rebound tachycardia, or an
anginal attack can occur.
7. Advise the client taking insulin that the β-adrenergic
blocker can mask early signs of hypoglycemia, such
as tachycardia and nervousness.
8. Instruct the client taking insulin to monitor the blood
glucose level.
9. Instruct the client in how to take pulse and BP.
10. Instruct the client to change positions slowly to
prevent orthostatic hypotension.
11. Instruct the client to avoid over-the-counter
medications, especially cold medications and nasal
decongestants.
XII. Calcium Channel Blockers (Box 53-15)

A. Description

1. Calcium channel blockers decrease cardiac
contractility (negative inotropic effect by relaxing
smooth muscle) and the workload of the heart, thus
decreasing the need for oxygen.
2. Calcium channel blockers promote vasodilation of the
coronary and peripheral vessels.

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