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Difficulty: MediumPharmacological Therapies

A client recovering on an orthopedic rehabilitation unit is prescribed a scheduled dose of oral carvedilol. The practical nurse assesses the client and notes a heart rate of 52 beats per minute and a blood pressure of 94/58 mm Hg. The client states, "I feel very lightheaded today." Which action should the practical nurse take?

  1. Withhold the carvedilol and promptly report the client's vital signs and symptoms to the registered nurse.Answer
  2. B
    Document the findings as an expected therapeutic response and administer the scheduled dose.
  3. C
    Ask the client to rate any current discomfort on a pain scale before proceeding with the administration.
  4. D
    Decrease the medication dose by half to prevent any further drops in the client's blood pressure.

Answer

The practical nurse should withhold the medication and notify the registered nurse.
Carvedilol is a beta-blocker that decreases cardiac output, heart rate, and blood pressure. The client is already experiencing bradycardia, hypotension, and symptomatic lightheadedness, which indicates decreased cerebral perfusion. Administering the medication would exacerbate these issues. The practical nurse must safely withhold the dose and communicate the findings to the supervising registered nurse for further clinical decisions.

Step-by-Step Solution

1
Analyze the client's vital signs and reported symptoms.
The heart rate is 52 bpm (bradycardia), blood pressure is 94/58 mm Hg (hypotension), and the client is lightheaded.
To determine if the scheduled medication is safe to administer based on current physiological parameters.
2
Identify the pharmacological action of carvedilol.
Carvedilol is a beta-blocker that decreases heart rate and blood pressure.
To predict how the drug will affect the client's current compromised cardiovascular status.
3
Determine the appropriate nursing intervention within the practical nurse scope of practice.
The medication must be held, and the abnormal findings must be reported to the RN or provider.
Administering the drug would worsen the condition, and modifying the dose is outside the PN scope of practice.

Key Concept

Safe administration of beta-blockers and practical nurse scope of practice regarding holding medications.
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Topics

Pharmacological Therapies

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