A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?

A. The client has a history of hypertension: Propranolol is commonly prescribed for both angina pectoris and hypertension. A history of hypertension is not a contraindication for taking propranolol. B. The client has a history of hypothyroidism: Hypothyroidism is not a contraindication for propranolol use. In fact, beta-blockers like propranolol can be used in clients with hypothyroidism for managing cardiovascular symptoms, this doesn’t require reporting. C. The client has a history of bronchial asthma: Propranolol is a non-selective beta-blocker, meaning it can block both beta-1 (heart) and beta-2 (lungs) receptors. Blocking beta-2 receptors in clients with asthma can cause bronchoconstriction and worsen respiratory symptoms. This is a significant contraindication and should be reported immediately. D. The client has a history of migraine headaches: Propranolol is actually sometimes prescribed for migraine prevention. Therefore, a history of migraines is not a concern with propranolol use, and there is no need to report this to the provider.