Which of these findings would cause the nurse to hold the administration of oral metoprolol 25 mg?
A.
Blood pressure of 92/44 mmHg
B.
Respiratory rate of 26 breaths per minute
C.
Heart rate of 92 beats per minute
D.
Oxygen saturation level of 95% on room air
The correct answer and Explanation is :
The correct answer is A. Blood pressure of 92/44 mmHg.
Metoprolol is a selective beta-blocker used primarily to manage hypertension, angina, and heart failure. It works by slowing the heart rate and reducing blood pressure. Therefore, when evaluating whether to administer metoprolol, the nurse must consider the patient’s current blood pressure and heart rate.
Explanation:
- Blood Pressure of 92/44 mmHg:
- Metoprolol lowers blood pressure by reducing cardiac output and systemic vascular resistance. If the patient’s blood pressure is already low, as indicated by a reading of 92/44 mmHg, administering metoprolol could exacerbate hypotension. Low blood pressure may lead to symptoms like dizziness, fainting, or even shock, which are dangerous and warrant holding the medication. Thus, a blood pressure reading below 100/60 mmHg typically raises concern about potential adverse effects from additional blood pressure reduction.
- Respiratory Rate of 26 breaths per minute:
- Although a respiratory rate of 26 breaths per minute indicates mild tachypnea, this finding is less directly related to the need to hold metoprolol. Metoprolol’s primary concern is its effect on heart rate and blood pressure, rather than on respiratory rate.
- Heart Rate of 92 beats per minute:
- A heart rate of 92 beats per minute is within a normal range for most individuals and does not necessarily indicate a need to withhold metoprolol. Metoprolol can affect heart rate, but a rate of 92 beats per minute is not considered bradycardic (unusually slow), which would be more concerning.
- Oxygen Saturation Level of 95% on Room Air:
- An oxygen saturation level of 95% is within normal limits and does not directly affect the decision to administer metoprolol. Metoprolol’s primary impact is on blood pressure and heart rate, not oxygen saturation levels.
In summary, a blood pressure of 92/44 mmHg would cause the nurse to withhold metoprolol because the medication could potentially lower the blood pressure further, leading to adverse effects.