A nurse is collecting data from a client prior to administration of verapamil. Which of the following findings indicates a need to withhold the medication?
A.
Blood pressure 170/82 mm Hg.
B.
Respiratory rate 18/min.
C.
Pulse rate 48/min.
D.
Potassium 4 mEq/L.
The correct answer and Explanation is :
The correct answer is C. Pulse rate 48/min.
Verapamil is a calcium channel blocker commonly used to treat hypertension, angina, and certain types of arrhythmias. One of its notable effects is to slow down the heart rate by decreasing the rate of conduction through the atrioventricular (AV) node.
Explanation:
- Pulse Rate of 48/min:
- Verapamil can significantly reduce heart rate due to its negative chronotropic effects. A pulse rate of 48 beats per minute is considered bradycardia. This finding is crucial because severe bradycardia (a heart rate under 60 beats per minute) can lead to insufficient blood flow to organs and tissues, causing symptoms like dizziness, fatigue, or even syncope.
- The presence of bradycardia indicates that verapamil could exacerbate the condition, potentially leading to adverse effects. Therefore, it is essential to withhold the medication and consult with a healthcare provider before administering it.
- Blood Pressure 170/82 mm Hg:
- Although a high blood pressure reading suggests hypertension, it is not a direct contraindication for administering verapamil. In fact, verapamil is used to manage high blood pressure. The healthcare provider might still proceed with the medication but would monitor the patient closely for effects on blood pressure.
- Respiratory Rate 18/min:
- A respiratory rate of 18 breaths per minute is within the normal range for adults. Verapamil does not typically affect respiratory rate significantly, so this finding does not indicate a need to withhold the medication.
- Potassium 4 mEq/L:
- A potassium level of 4 mEq/L is within the normal range (typically 3.5-5.0 mEq/L). Verapamil does not significantly affect potassium levels directly, so this finding does not warrant withholding the medication.
In summary, the presence of bradycardia (pulse rate of 48/min) is a significant finding that suggests the need to withhold verapamil and seek further evaluation, as the medication could worsen bradycardia or lead to additional complications.