The nurse takes a patient's vital signs prior to giving metoprolol tartrate and obtains the following results: T 98 degrees F, P 48, R 16 bpm, BP 100/50 and a pulse oximeter of 98%. What action will the nurse take?
Continue to administer the metoprolol tartrate as ordered.
Ask the patient if her pulse is within the normal range
Hold the medication and call the provider
Ask the patient to eat salty foods
The Correct Answer is C
A. Continue to administer the metoprolol tartrate as ordered:
Metoprolol is a beta-blocker commonly used to treat hypertension, angina, and heart failure. One of its main effects is to decrease heart rate and blood pressure. In this scenario, the patient's vital signs reveal a low heart rate (48 bpm) and relatively low blood pressure (100/50 mmHg). Given that metoprolol can further reduce heart rate and blood pressure, it would be prudent for the nurse to withhold the medication until further assessment is conducted.
B. Ask the patient if her pulse is within the normal range:
While it's essential to assess the patient's understanding of her condition, asking if her pulse is within the normal range is not sufficient. The nurse should perform a more thorough assessment and consider the clinical significance of the vital signs obtained. In this case, a heart rate of 48 bpm is lower than the typical normal range for adults (60-100 bpm), indicating bradycardia, which may be symptomatic or concerning in the context of administering a beta-blocker like metoprolol.
C. Hold the medication and call the provider:
Given the patient's low heart rate (bradycardia) and relatively low blood pressure, holding the metoprolol tartrate and contacting the healthcare provider is the most appropriate action. Bradycardia and hypotension can be signs of excessive beta-blockade, especially with medications like metoprolol, which can further lower heart rate and blood pressure. The nurse should notify the provider promptly to discuss the patient's condition and determine the appropriate course of action.
D. Ask the patient to eat salty foods:
Encouraging the patient to eat salty foods would not address the underlying issue of bradycardia and hypotension. While increasing salt intake may help raise blood pressure in some cases, it is not a standard intervention for managing symptomatic bradycardia or low blood pressure caused by medication effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Muscle cramps: While muscle cramps can occur with hypertension, they are not specific indicators of target organ damage. Muscle cramps are more commonly associated with electrolyte imbalances or peripheral vascular disease.
B. Bounding pulses: Bounding pulses can indicate increased stroke volume and cardiac output, which may occur in response to chronic hypertension. However, they are not direct indicators of target organ damage.
C. Vision changes: Vision changes, such as blurred vision or vision loss, can be indicative of hypertensive retinopathy, a complication of chronic hypertension affecting the blood vessels in the retina. These changes may manifest as decreased visual acuity, floaters, or even sudden vision loss and are considered signs of target organ damage.
D. Increased energy: Increased energy is not typically associated with target organ damage in the context of chronic hypertension. It may be a result of various factors unrelated to hypertension, such as improved sleep quality or changes in lifestyle habits.
Correct Answer is D
Explanation
A. "Has anyone in your family ever experienced symptoms similar to yours?":
This question aims to gather information about potential familial illnesses or infections but does not specifically address the possible etiology of human immunodeficiency virus (HIV). While HIV can be transmitted vertically from mother to child, asking about family members' symptoms is less directly relevant to the assessment of HIV exposure.
B. "How many alcoholic drinks do you typically consume in a week?":
This question assesses the patient's alcohol consumption habits and is important for evaluating overall health and potential risk factors for various conditions. However, it does not directly address the possible etiology of human immunodeficiency virus (HIV). Alcohol consumption may affect immune function but is not a primary indicator of HIV exposure.
C. "To the best of your knowledge, are your immunizations up to date?":
This question is aimed at assessing the patient's immunization status and is essential for preventive healthcare. However, it does not directly address the possible etiology of human immunodeficiency virus (HIV). Immunizations primarily protect against infectious diseases caused by bacteria or viruses other than HIV.
D. "Have you recently had unprotected intercourse with a new partner?":
This question directly addresses behaviors that could lead to HIV transmission. Unprotected sexual intercourse with a new partner is a significant risk factor for acquiring HIV, as the virus can be transmitted through sexual contact with an infected individual. Asking about recent sexual activity helps identify potential exposure to HIV and informs appropriate testing and counseling.
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