After the nurse teaches the patient about the use of atenolol (Tenormin) in preventing anginal episodes, which statement by a patient indicates that the teaching has been effective?

Question

BlackTom AI · Accepted Answer

Atenolol is a beta1-selective adrenergic blocker that decreases heart rate and myocardial contractility, thereby lowering myocardial oxygen demand and helping prevent ischemic anginal episodes.

1) Relevant knowledge points and concepts:
- Beta1 receptors are primarily in the heart; blocking them reduces chronotropy (heart rate) and inotropy (contractile force).
- Reduced heart rate and contractility lower oxygen demand, reducing frequency/severity of angina.
- Abrupt withdrawal of beta-blockers can cause rebound sympathetic overstimulation (tachycardia, hypertension) and precipitate angina or myocardial infarction, so gradual tapering is required.
- Atenolol is not primarily a coronary vasodilator and does not strengthen myocardium; while bronchospasm is more a concern with nonselective beta-blockers, respiratory side effects are not an expected intended effect for most patients.

2) Step-by-step reasoning:
- Mechanism: atenolol blocks cardiac beta1 receptors → decreases HR and contractility → lowers myocardial O2 demand → prevents anginal episodes.
- Teaching goal: patient should understand how to take it safely and what to expect.
- Critical safety point: stopping a beta-blocker suddenly allows unopposed sympathetic activity → rebound tachycardia and increased O2 demand → potential worsening of angina or precipitating MI.
- Therefore a correct patient statement should reflect awareness of the need to taper/discontinue carefully.

3) Calculations: none required.

4) Why the correct answer is correct:
- “It is important not to suddenly stop taking the atenolol.” directly reflects the vital clinical teaching about avoiding abrupt discontinuation to prevent rebound cardiac events. This is a principal safety message for beta-blocker therapy.

5) Why the other options are incorrect:
- “Atenolol will increase the strength of my heart muscle.” Incorrect — atenolol is a negative inotrope (it reduces contractility).
- “I can expect to feel short of breath when taking atenolol.” Incorrect as a general expectation — atenolol does not normally cause dyspnea in most patients; significant bronchospasm is mainly a risk with nonselective beta-blockers and in patients with reactive airway disease.
- “Atenolol will improve the blood flow to my coronary arteries.” Incorrect — atenolol reduces myocardial oxygen demand rather than directly increasing coronary blood flow.

Conclusion: The teaching is effective if the patient says, “It is important not to suddenly stop taking the atenolol,” which matches the provided correct answer.

After the nurse teaches the patient about the use of atenolol (Tenormin) in preventing anginal episodes, which statement by a patient indicates that the teaching has been effective?单项选择题

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