A nurse is discussing with a client who knows someone taking metoprolol for blood pressure management. The client inquires whether metoprolol would be suitable for her as well. Based on the client's medical record, which of the following should the nurse recognize as a contraindication to metoprolol?

Choice A reason: Cough is not commonly associated with atenolol. Atenolol is a beta-blocker used to treat hypertension and is less likely to cause respiratory side effects compared to some other classes of antihypertensive medications.

Choice B reason: Bradycardia, or a slower than normal heart rate, is a well-documented adverse effect of atenolol. Atenolol works by blocking beta-1 receptors in the heart, which can reduce the heart rate. Normal heart rate ranges for infants (1 to 11 months old) are 80-160 beats per minute (BPM), and for toddlers (1-2 years old), it's 80-130 BPM. Bradycardia would be defined as a heart rate below these normal ranges. It is important for patients starting atenolol to monitor their pulse regularly and report any significant decrease in heart rate to their healthcare provider.

Choice C reason: While constipation can be a side effect of many medications, it is not a common adverse effect of atenolol. Atenolol does not typically affect the gastrointestinal system to the extent that it causes constipation.

Choice D reason: Headache is not a typical adverse effect of atenolol. While headaches can occur for a variety of reasons, they are not directly linked to the pharmacological action of atenolol on the cardiovascular system.

Choice A reason : Morphine is an opioid analgesic used to relieve severe pain and can be administered to patients with myocardial infarction to alleviate chest pain and anxiety. However, it is not the first medication given as it does not address the underlying cause of the myocardial infarction, which is the formation of a blood clot in the coronary arteries.

Choice B reason : Nitroglycerin is a nitrate that helps to dilate blood vessels and improve blood flow. It can be used to relieve chest pain in myocardial infarction, but similar to morphine, it is not the initial medication of choice. The priority is to prevent further blood clotting.

Choice C reason : Administered as soon as possible to inhibit platelet aggregation and reduce clot progression.

Choice D reason : When a myocardial infarction (MI) is suspected, the priority is to address tissue hypoxia and ensure adequate oxygenation to minimize myocardial damage. Administering oxygen helps increase oxygen availability to the ischemic heart tissue, reducing further damage.