A nurse is preparing to give routine medications to a client with a history of hypertension. The nurse recognizes the need to assess the clients blood pressure before and after administering which of the following medications?

A. Having the patient splint their incision site when coughing and deep breathing:
While splinting the incision site can help alleviate pain and prevent strain on the surgical wound during coughing and deep breathing, it is not a primary intervention for preventing surgical site infection. Infection prevention is more directly related to sterile technique, antibiotic prophylaxis, and maintaining a clean environment around the wound. Splinting can support postoperative recovery, but it does not directly prevent infection.

B. Offering around the clock pain medication in the immediate post-operative phase:
Providing pain medication is important for patient comfort and to facilitate early mobilization after surgery. However, pain management does not directly prevent surgical site infections. The focus for infection prevention lies in maintaining sterility, administering antibiotics as prescribed, and appropriate wound care rather than pain control alone.

C. Administering prescribed pre-operative antibiotics within 30-60 minutes of surgery:
The administration of prophylactic antibiotics before surgery, typically within 30-60 minutes of the incision, is a primary intervention for preventing surgical site infections (SSIs). This timing ensures that the antibiotics are at therapeutic levels in the bloodstream when the surgical procedure begins, reducing the risk of introducing bacteria into the surgical site. This is a well-established guideline for infection prevention in surgical settings.

D. Performing the first dressing change on a new surgical site in the postoperative setting:
The first dressing change should generally be done by a healthcare professional using sterile technique. However, the timing and handling of the first dressing change are more related to wound care practices rather than a primary strategy for preventing infection. Infection prevention primarily involves proper antibiotic prophylaxis, maintaining a sterile field, and managing the surgical site during the early post-operative period. The first dressing change, while important for wound healing, is not the most immediate or primary intervention for preventing surgical site infection.

A) Simvastatin: Simvastatin is a medication used to lower cholesterol levels and does not typically require monitoring of blood pressure before or after administration. While statins may have some indirect cardiovascular benefits, blood pressure is not directly affected by this medication, so it is not necessary to assess blood pressure before or after administering simvastatin.

B) Metoprolol: This is the correct answer. Metoprolol is a beta-blocker commonly used to treat hypertension and other cardiovascular conditions. It works by reducing heart rate and blood pressure. Therefore, it is important to assess the client's blood pressure both before and after administering metoprolol to ensure the medication is having the desired effect and to detect any adverse changes, such as hypotension or bradycardia.

C) Acetylsalicylic Acid (Aspirin): Aspirin is primarily used for its antiplatelet effect, such as for preventing heart attacks or strokes, and it does not have a significant direct impact on blood pressure. While aspirin can have side effects, such as gastrointestinal irritation or bleeding, blood pressure monitoring is generally not necessary before or after administering aspirin.

D) Metformin: Metformin is used to manage type 2 diabetes by helping control blood glucose levels. It does not directly affect blood pressure, so routine blood pressure assessment is not required before or after giving metformin. However, monitoring for side effects like gastrointestinal distress or lactic acidosis is important, but blood pressure is not a priority for this medication.