Which factors may contribute to hypertension? (Select All that Apply.)

(A) Blood pressure 160/94 mm Hg:
Metoprolol is a beta-blocker commonly used to treat hypertension. A blood pressure reading of 160/94 mm Hg indicates hypertension, which is an indication for administering metoprolol, not withholding it.

(B) Oxygen saturation 95%:
An oxygen saturation of 95% is within the normal range and does not provide a reason to withhold metoprolol. Oxygen saturation levels are not directly impacted by this medication in a way that would warrant withholding it.

(C) Heart rate 50/min:
A heart rate of 50/min is bradycardia (a slow heart rate). Metoprolol can further lower the heart rate, so it should be withheld if the client is already experiencing bradycardia. The nurse should notify the healthcare provider for further instructions.

(D) Respiratory rate 18/min:
A respiratory rate of 18/min is within the normal range (12-20 breaths per minute) and does not provide a reason to withhold metoprolol. Respiratory rate is not typically a contraindication for this medication unless there are specific respiratory conditions or other related symptoms present.

(A) “Incorporate walking into your daily routine.”: This is the most appropriate instruction for a client with peripheral arterial disease (PAD). Regular exercise, such as walking, can help improve circulation, increase the distance a person can walk without pain, and promote overall cardiovascular health. It’s important to start slow and gradually increase the duration and intensity of the exercise as tolerated. The client should be advised to stop and rest if they experience any pain.

(B) “Elevate your legs while in bed.”: While elevating the legs can help reduce swelling in some conditions, it’s not typically recommended for clients with PAD. Elevation can actually decrease arterial blood flow to the legs, which could worsen symptoms.

(c) “Shop for new shoes during the morning hours.”: This instruction is more relevant for clients with conditions that cause foot swelling, such as heart failure or venous insufficiency. In PAD, the size of the feet does not typically change throughout the day.

(D) “Wear knee length stockings.”: Compression stockings are often used to improve venous circulation in conditions like deep vein thrombosis or chronic venous insufficiency. However, they’re not typically recommended for clients with PAD as they can restrict arterial blood flow.