Questions and Answers
What is the nurse's primary intervention for a client who has stopped taking metoprolol due to affordability?
Assess the client's blood pressure.
What is the highest priority potential nursing diagnosis for a client starting on metoprolol?
Decreased cardiac output related to effects of medication.
For the client taking epinephrine, the nurse realizes there is a possible drug interaction with which drug?
What condition should the nurse monitor for in a client prescribed metoprolol?
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What is the priority nursing diagnosis for a patient taking metoprolol?
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What should be taught to a patient about beta blockers such as metoprolol?
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What nursing interventions are associated with I.V. metoprolol administration for a patient after an acute myocardial infarction?
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What important teaching should be provided regarding the use of beta-blockers?
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Study Notes
Metoprolol Overview
- Metoprolol (Lopressor) is a beta-adrenergic blocker used primarily to manage hypertension, angina, and heart attack recovery.
- Abrupt discontinuation can lead to rebound hypertension, necessitating careful weaning off.
Nursing Interventions
- Primary Action: Assess blood pressure if a client reports stopping the medication due to cost, as sudden withdrawal can cause significant spikes in blood pressure.
- Monitor heart rate before administering metoprolol; withhold the medication if apical pulse is below 60 beats/min or if systolic BP is below 90 mm/Hg.
- Significant post-myocardial infarction nursing tasks include monitoring glucose levels closely in diabetic patients, checking for bradycardia or heart block, and closely observing blood pressure.
Nursing Diagnoses
- High Priority: Decreased cardiac output is the most critical nursing diagnosis for clients starting on metoprolol due to its potential effects on heart function.
- Ineffective tissue perfusion (cerebral and cardiovascular) is also a priority due to risks associated with the medication.
Drug Interactions
- Metoprolol may interact with epinephrine; caution is advised when these medications are used together.
Side Effects and Monitoring
- Bradycardia is a significant side effect; regular monitoring is essential.
- Abrupt withdrawal can trigger a hypertensive crisis, highlighting the importance of patient education on the medication's gradual tapering.
Patient Education
- Inform patients that mixing beta-blockers with alcohol is discouraged, as it can exacerbate side effects, rather than enhance therapeutic effects.
- Emphasize the importance of contacting healthcare providers regarding any side effects or concerns with medication adherence.
Therapeutic Effects
- One anticipated benefit of metoprolol therapy includes a decrease in heart rate and overall blood pressure, promoting better cardiovascular health.
- Beta-blockers may initially increase fatigue levels but contribute significantly to long-term health improvements.
Important Considerations
- Metoprolol may mask hypoglycemia symptoms; diabetic patients should monitor their blood sugar closely while on this medication.
- Compatibility with other drugs varies; metoprolol has unique considerations for mixing with other medications, especially in IV forms.
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Description
This quiz focuses on metoprolol, a common beta-blocker used in managing hypertension. It addresses key nursing interventions when patients discontinue this medication abruptly. Test your knowledge of important nursing practices related to this drug.
