Antitussives are useful in blocking the cough reflex and preserving the energy associated with prolonged, nonproductive coughing. Antitussives are best used with

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.

A) Respiratory rate 18/min:
A respiratory rate of 18/min is within the normal range for adults and is not a contraindication for administering atenolol. This finding does not warrant withholding the medication.

B) Oxygen saturation 95%:
An oxygen saturation of 95% is within the normal range and does not indicate any acute respiratory compromise. It is not a contraindication for administering atenolol.

C) Heart rate 46/min:
A heart rate of 46/min is below the normal range (typically 60-100 beats per minute for adults). Atenolol is a beta-blocker that primarily acts to reduce heart rate and blood pressure. Administering atenolol to a client with bradycardia (heart rate less than 60/min) can further decrease heart rate and may lead to symptomatic bradycardia or heart block. Therefore, the nurse should withhold atenolol in this case and notify the healthcare provider.

D) Blood pressure 160/94 mm Hg:
A blood pressure of 160/94 mm Hg indicates hypertension (elevated blood pressure). While atenolol is often prescribed for the management of hypertension, this blood pressure reading alone does not warrant withholding the medication. However, the client's bradycardia (heart rate 46/min)’is a more immediate concern that requires action."