Lillian has been on her medication for pneumonia for 24 hours.The MD says the pneumonia is improving, but she also is having anacute exacerbation of her COPD and a chronic irregular heart rate.Her vital signs are T 37C, B/P 140/87, P 82 and irregular, R 12,and pulse oximetry 92% on 2L O2 per nasal cannula. The physician isconcerned about her blood pressure and wants to continue to watchit. She feels that Lillian will benefit from regular medication forher COPD while in the hospital and when she goes home. Lillian alsois complaining of cigarette cravings and constipation. The MD isurging her to quit smoking.
The physician leaves the following orders.
Albuterol MDI 2 puffs every 6 hours
Ipratropium MDI 2 puffs every 6 hours
Nicoderm 7mg/24hr transdermal patch daily
Bisacodyl 10 mg suppository now x1 then 10 mg po daily
Bathroom privileges
Respiratory therapist to determine need for O2 at home
Cardiologist, Dr. B, to consult for irregular heart rate
The patient will probably will need an anti-hypertensivemedication added to her list of medications. What are someanti-hypertensive medications the physician will probably avoid andwhy?