A practical nurse (PN) is reviewing the medication administration record (MAR) and current vital signs for a client who is 24 hours postoperative following a bowel resection. The client is scheduled to receive a dose of oral metoprolol. The client's vital signs are: temperature 98.6°F (37.0°C), heart rate 118 beats/minute, respiratory rate 22 breaths/minute, and blood pressure 88/54 mm Hg. The client reports mild dizziness. Which action is the priority for the PN?
- AAdminister the metoprolol as prescribed to help reduce the client's elevated heart rate.
- BAdminister the medication with a small sip of water and instruct the client to remain in bed to prevent falls.
- Withhold the metoprolol and immediately report the client's vital signs to the registered nurse.Answer
- DVerify the client using two distinct identifiers and the barcode scanner before giving the medication.
Answer
The priority action is to withhold the metoprolol and immediately report the client's vital signs to the registered nurse.
The client is exhibiting signs of potential hypovolemic shock (hypotension, compensatory tachycardia, dizziness) following major surgery. Metoprolol is a beta-blocker that lowers both heart rate and blood pressure. Administering this medication would eliminate the body's compensatory mechanism (tachycardia) and further decrease the blood pressure, potentially leading to cardiovascular collapse. Within the practical nursing scope of practice, the nurse must withhold the medication and immediately escalate these critical findings to the registered nurse for urgent assessment and intervention.
Step-by-Step Solution
Key Concept
Safe Medication Administration: Recognizing Contraindications and Scope of Practice
Estimated Time:1m 15s