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Zorluk: KolayPharmacological Therapies

A client prescribed oral metoprolol for hypertension is resting in bed. Before giving the morning dose, the practical nurse obtains an apical pulse of 48 beats/minute48 \text{ beats/minute}. What is the most appropriate action for the nurse to take?

  1. A
    Give the medication as ordered and reassess the heart rate in 30 minutes30 \text{ minutes}.
  2. B
    Administer half of the prescribed dose to prevent further lowering of the heart rate.
  3. Withhold the scheduled dose and promptly notify the registered nurse.Cevap
  4. D
    Ask the client to ambulate in the hallway to raise their heart rate before administration.

Cevap

The practical nurse should withhold the metoprolol and notify the registered nurse because the client's heart rate is below the safe administration threshold.
Metoprolol is a beta-adrenergic blocking agent that decreases both blood pressure and heart rate. The standard of care requires withholding the medication if the apical pulse is less than 60 beats/minute60 \text{ beats/minute} and reporting the finding to the supervising registered nurse or healthcare provider so they can provide further clinical judgment.

Adım Adım Çözüm

1
Evaluate the client's current apical pulse against the expected parameters for the prescribed medication.
The pulse of 48 beats/minute48 \text{ beats/minute} is below the standard 60 beats/minute60 \text{ beats/minute} threshold for administering a beta-blocker.
Metoprolol decreases heart rate; giving it to a bradycardic client can cause severe hemodynamic compromise.
2
Determine the appropriate intervention based on the practical nurse's scope of practice.
The correct action is to withhold the dose and escalate the abnormal finding.
The practical nurse must recognize abnormal vital signs, withhold potentially harmful medications, and report to the supervising registered nurse or provider.

Anahtar Kavram

Pre-administration vital sign parameters for beta-blockers and practical nurse scope of practice.
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Konular

Pharmacological Therapies

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