A nurse is preparing to administer a 5 mg IV bolus of metoprolol to a patient for heart rate control.

The available metoprolol injection is 1 mg/mL. How many mL should the nurse administer per dose?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A rationale

Propranolol is sometimes used to prevent migraines, so a history of migraines would not typically be a contraindication.

Choice B rationale

Hypothyroidism is not typically a contraindication for propranolol. However, propranolol can affect the metabolism of thyroid hormones and may mask signs of hyperthyroidism.

Choice C rationale

Propranolol is often used to treat hypertension, so a history of hypertension would not typically be a contraindication.

Choice D rationale

Propranolol is a non-selective beta-blocker, which means it blocks beta receptors in both the heart and the lungs. This can potentially cause bronchoconstriction and exacerbate asthma symptoms, so it should be used with caution in patients with a history of bronchial asthma.

Essential

1. Monitoring respiratory rate closely: The client is breathing rapidly and appears anxious, making close monitoring crucial to ensure timely intervention and management of respiratory issues.

2. Providing reassurance and calming interventions: The client is anxious and discomforted. Providing reassurance and calming interventions is important to address their immediate emotional and psychological needs.

3. Checking electrolyte levels regularly: Given the client's symptoms and the need for ongoing monitoring, checking electrolyte levels is essential for managing their condition effectively.

Nonessential

1. Administering antiemetic medication: While helpful for managing nausea, this action is not immediately critical compared to other interventions that address more urgent needs.

Contraindicated

1. Encouraging the client to sit up without assistance: The client feels faint and is unsteady when sitting up. Encouraging them to sit up without assistance could be dangerous and may increase the risk of falls or injuries.

2. Increasing IV fluid rate: The current IV fluid rate is prescribed by the provider. Increasing it without further assessment could lead to complications and should be avoided unless directed by a healthcare provider.