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. Sedentary lifestyle: While a sedentary lifestyle can contribute to the development and progression of peripheral arterial disease (PAD), it is not the highest risk factor compared to other options listed. Regular physical activity is important for cardiovascular health and can help reduce the risk of PAD, but other risk factors may have a greater impact on disease development.
B. Diabetes: Diabetes is a significant risk factor for PAD, especially when poorly controlled. High blood sugar levels can damage blood vessels and nerves, leading to atherosclerosis and reduced blood flow to the limbs. However, compared to cigarette smoking, diabetes may not be considered the highest risk factor for PAD.
C. Cigarette smoking: Cigarette smoking is the highest risk factor for peripheral arterial disease (PAD). Tobacco smoke contains numerous harmful chemicals that damage blood vessels and promote atherosclerosis, narrowing the arteries and reducing blood flow to the limbs. Smoking not only increases the risk of developing PAD but also accelerates its progression and worsens symptoms. Quitting smoking is one of the most important interventions for preventing and managing PAD.
D. Hyperlipidemia: Elevated levels of cholesterol and triglycerides (hyperlipidemia) contribute to the development of atherosclerosis, which is a key mechanism underlying peripheral arterial disease (PAD). However, while hyperlipidemia is a significant risk factor, it may not be considered the highest risk factor compared to cigarette smoking. Controlling cholesterol levels through lifestyle changes and medications is essential for managing PAD and reducing cardiovascular risk.
Correct Answer is C
Explanation
A. Assess nutritional status with height, weight, blood urea nitrogen, transferrin, hemoglobin, and hematocrit level: This option focuses on assessing the patient's nutritional status, which is important for planning appropriate interventions. However, in a patient presenting with severe diarrhea and vomiting, the priority is to address immediate physiological needs and stabilize the patient's condition before conducting comprehensive assessments. While assessing nutritional status is important for long-term management, it is not the first action the nurse should take in this acute situation.
B. Consult with a dietitian to determine the patient's nutritional needs: Consulting with a dietitian is an important step in addressing the patient's nutritional needs, especially in cases of prolonged diarrhea and vomiting. However, in this scenario, the patient is experiencing severe symptoms that require immediate attention. Before consulting with a dietitian, the nurse should address the patient's acute symptoms and initiate interventions to manage fluid and electrolyte imbalances.
C. Encourage the patient to prepare simple meals or to obtain assistance with meal preparation if possible: This option addresses the immediate need to provide nutritional support to the patient. Encouraging the patient to consume simple, easily digestible meals or to seek assistance with meal preparation helps ensure that the patient receives adequate nutrition despite experiencing symptoms of diarrhea and vomiting. Providing practical advice on meal preparation empowers the patient to take control of their nutritional intake, which can be beneficial in managing symptoms and promoting recovery.
D. Encourage the patient to eat meals with visitors or others when possible: While social support and companionship can have a positive impact on the patient's overall well-being, including their nutritional intake, this option is not the first priority in this scenario. The patient's severe symptoms of diarrhea and vomiting require immediate attention to address fluid and electrolyte imbalances and prevent complications such as dehydration. Once the patient's condition stabilizes, encouraging social interaction during meals can be beneficial for promoting nutritional intake and emotional support.
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