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Difficulty: EasyPharmacological Therapies

An adult client on a telemetry unit is prescribed oral metoprolol for hypertension. When implementing safe medication practices for this client, which actions should the practical nurse include? Select all that apply.

  1. Confirm the client's identity using two distinct identifiers prior to dispensing the tablet.Answer
  2. Assess the client's apical heart rate and withhold the dose if it is below 60 beats per minute.Answer
  3. C
    Mentally estimate the conversion of a liquid alternative if the client cannot swallow the pill.
  4. D
    Agree to administer the metoprolol via direct intravenous push if requested by the registered nurse.
  5. E
    Scan the medication barcode but bypass scanning the client's wristband if the client is resting quietly.
  6. Review the electronic health record for the most recent blood pressure measurement.Answer

Answer

The correct actions include confirming the client's identity using two identifiers, assessing the apical heart rate and withholding if below 60 beats per minute, and reviewing the most recent blood pressure measurement.
Safe administration of beta-blockers requires specific pre-administration assessments and strict adherence to medication safety rights. The practical nurse must obtain the client's current blood pressure and an apical pulse for a full minute, withholding the medication if the heart rate is less than 60 beats per minute. Furthermore, fundamental safety principles dictate that the nurse must always use at least two distinct client identifiers to ensure the right medication is given to the right person.

Step-by-Step Solution

1
Identify the classification and effects of the prescribed medication.
Metoprolol is a beta-blocker, which lowers both heart rate and blood pressure.
Understanding the drug's mechanism dictates the necessary pre-administration clinical assessments.
2
Determine the required safety assessments before administering a beta-blocker.
The nurse must check the apical pulse (withholding if < 60 bpm) and the blood pressure.
Administering the medication without these checks could cause dangerous bradycardia or hypotension.
3
Evaluate the remaining options against the standard scope of practice and medication safety rights.
Mental dosage calculations, intravenous push administration, and bypassing barcode scanning are all unsafe or out-of-scope practices.
Practical nurses must adhere strictly to their defined scope of practice and universally accepted medication safety protocols.

Key Concept

Safe medication administration involves verifying patient identity, adhering to the practical nursing scope of practice, and performing specific pre-administration assessments based on the drug's physiological effects.
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Pharmacological Therapies

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