A nurse is collecting data from a client prior to administering metoprolol. For which of the following findings should the nurse withhold the medication?

(a) Heart rate of 66/min:
A heart rate of 66/min is within the normal range (60-100 bpm) and does not typically require contacting the provider before administering a calcium channel blocker. CCBs can affect heart rate, but this finding alone is not a contraindication for their use.

(b) BP of 148/94 mm Hg:
A blood pressure reading of 148/94 mm Hg indicates hypertension, which is an appropriate indication for the use of calcium channel blockers. This finding supports the use of the medication rather than requiring the provider to be contacted.

(c) Peripheral edema of the ankles:
Peripheral edema is a known side effect of calcium channel blockers. If the client is already experiencing edema, administering the medication could potentially worsen this condition. The nurse should contact the provider to discuss this finding before proceeding with the medication administration.

(d) A digoxin level of 1.2 ng/mL:
A digoxin level of 1.2 ng/mL is within the therapeutic range (0.5-2.0 ng/mL). This finding does not necessitate contacting the provider before administering a calcium channel blocker, as it does not indicate toxicity or a contraindication for CCB use

A. "Opioid narcotics are restricted for the client because of the risk for addiction":
This statement is not accurate and may contribute to unnecessary fear or misunderstanding about opioid use. While there is a risk of opioid addiction, it is generally low when opioids are used appropriately for pain management, especially in end-of-life care settings where the focus is on comfort and symptom management.

B. "Using opioid narcotics will limit options available for future management of pain":
This statement is misleading and may cause unnecessary concern. In end-of-life care, the priority is to provide effective pain relief and maximize comfort for the client. Opioid narcotics are an essential component of pain management in palliative and hospice care and do not necessarily limit future pain management options.

C. "The use of opioid narcotics is restricted to when death is imminent":
This statement is not accurate. Opioid narcotics can be used for pain management at various stages of illness, including but not limited to end-of-life care. While opioids are commonly used in palliative and hospice care settings, they may also be indicated for pain management in other clinical contexts.

D. "The dosage of the opioid narcotic is unlimited":
This statement is the most appropriate response. In end-of-life care, the goal of pain management is to relieve suffering and maximize comfort. Opioid dosages are titrated based on the client's pain intensity and response, and there is no strict limit to the dosage if needed to achieve adequate pain control. The priority is to ensure that the client is comfortable and free from pain as much as possible, even if higher doses of opioids are required.