Nursing consideration: should be avoided in pregnant women after the first trimester because it may may result in low birth weight infants. salt and alcohol should be resteicted, tasks that require mental alertness or motor skills should be avoided. notify physician of behavioral changes, fatigue, dizziness, excessive slow pulse, shortness of breath, ECG for arrhythmias, pulse for quality, rate, and rhythm should be monitored during treatment, blood glucose levels should be monitored after the initial therapy in patients with diabetes mellitus because propranolol can cause hyperglycemic effects.