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

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Changes in peristalsis: Changes in peristalsis, which refers to the rhythmic contraction and relaxation of the gastrointestinal tract muscles, are not typically associated with target organ damage in hypertension. While hypertension can indirectly affect gastrointestinal function through its impact on other organ systems, such as the kidneys and cardiovascular system, alterations in peristalsis are more commonly attributed to gastrointestinal disorders or neurological conditions rather than hypertension-induced target organ damage.

B. Decreased urine output: In a patient diagnosed with hypertension, decreased urine output may indicate the development of target organ damage, particularly renal damage. Hypertension can lead to chronic kidney disease (CKD) over time, which is characterized by a gradual decline in kidney function. Decreased urine output may be a sign of impaired renal function, reduced glomerular filtration rate (GFR), or the presence of proteinuria. These changes indicate that the kidneys are no longer effectively filtering waste products and regulating fluid balance, suggesting the onset of renal damage as a consequence of long-standing hypertension.

C. Decreased insulin resistance: Hypertension is not directly linked to changes in insulin resistance. However, hypertension and insulin resistance are often comorbid conditions that share common risk factors, such as obesity, sedentary lifestyle, and unhealthy diet. While poorly controlled hypertension and insulin resistance can contribute to the development of cardiovascular disease and other complications, a decrease in insulin resistance would not typically be considered an indicator of target organ damage in hypertension.

D. Hypercholesterolemia: Hypercholesterolemia, or high levels of cholesterol in the blood, is a risk factor for cardiovascular disease, including atherosclerosis and coronary artery disease. While hypertension and hypercholesterolemia frequently coexist and contribute to the progression of vascular damage, the presence of hypercholesterolemia alone does not necessarily indicate target organ damage specific to hypertension. However, elevated cholesterol levels can exacerbate vascular changes and increase the risk of cardiovascular events in individuals with hypertension.

A. Review serum electrolytes B. Request the patient's food diary C. Place the patent on bed rest D. Observing vital signs

Correct Answer is A

Explanation

A. Review serum electrolytes: Muscle cramps can be associated with electrolyte imbalances, such as hypokalemia (low potassium levels), which can occur as a side effect of ARB medications. Therefore, reviewing the patient's serum electrolyte levels, including potassium, can help identify any abnormalities that may be contributing to the muscle cramps. If hypokalemia is present, appropriate interventions such as potassium supplementation or adjustment of the ARB dosage may be necessary to alleviate the muscle cramps.

B. Request the patient's food diary: While assessing the patient's food diary may provide information about their dietary habits and potential factors contributing to muscle cramps (such as dehydration or inadequate nutrient intake), it may not directly address the potential electrolyte imbalance associated with ARB use. Therefore, while obtaining a food diary may be relevant, it is not the priority action in this scenario.

C. Place the patient on bed rest: Placing the patient on bed rest is not indicated solely based on complaints of muscle cramps. Muscle cramps can have various causes, and restricting the patient's activity may not address the underlying issue. Additionally, bed rest could lead to other complications such as deconditioning or venous thromboembolism, which are not warranted in this situation.

D. Observing vital signs: While monitoring vital signs is a routine nursing intervention, it may not directly address the patient's complaint of muscle cramps. Vital signs may be relevant in assessing overall health status, but they may not provide specific information about the cause of muscle cramps or guide appropriate interventions.

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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?

Nursing Test Bank

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Correct Answer is B

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Correct Answer is A

Explanation

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