A nurse caring for a client”who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

Find the concentration of heparin in the solution:

Total heparin (units): 25,000 units

Volume of solution (mL): 500 mL

Heparin concentration (units/mL) = Total heparin (units) / Volume of solution (mL)

Heparin concentration (units/mL) = 25,000 units / 500 mL = 50 units/mL

Set up the flow rate equation:

Desired heparin infusion rate (units/hr): 1600 units/hr

Heparin concentration in solution (units/mL): 50 units/mL

Flow rate (mL/hr): We need to solve for this

Flow rate (mL/hr) = Desired heparin infusion rate (units/hr) / Heparin concentration (units/mL)

Calculate the flow rate (mL/hr):

Flow rate (mL/hr) = 1600 units/hr / 50 units/mL = 32 mL/hr (round to nearest whole number as requested)

Therefore, the nurse should set the IV pump to deliver approximately 32 mL/hr.

A) Temperature and respiratory rate:
While monitoring temperature and respiratory rate are important aspects of a comprehensive assessment, they are not the priority assessments before administering metoprolol. Metoprolol is a beta-blocker primarily used to lower heart rate and blood pressure, so assessing the client's heart rate and blood pressure is more relevant.

B) Heart rate and blood pressure:
This is the correct answer. Before administering metoprolol, it is essential to assess the client's heart rate and blood pressure. Metoprolol is a beta-blocker medication that primarily affects heart rate and blood pressure. Monitoring these vital signs helps ensure that the medication is administered safely and effectively.

C) Level of consciousness and pain level:
Assessing the client's level of consciousness and pain level are important aspects of nursing care, but they are not the priority assessments before administering metoprolol. These assessments may be relevant depending on the client's overall condition and specific care needs, but they are not directly related to the action or side effects of metoprolol.

D) Oxygen saturation and respiratory rate:
Monitoring oxygen saturation and respiratory rate are important aspects of respiratory assessment, but they are not the priority assessments before administering metoprolol. While metoprolol can affect respiratory function as a potential side effect, its primary action is on heart rate and blood pressure. Therefore, assessing heart rate and blood pressure are more pertinent before administering this medication.