A nurse is caring for a client who has been taking propranolol. Which of the following findings indicates a need to withhold the medication?
A.
Blood pressure 156/90 mm Hg
B.
Pulse 54/min
C.
Potassium 5.2 mEq/L
D.
Sodium 130 mEq/L
The Correct answer and Explanation is:
The correct answer is B. Pulse 54/min.
Explanation:
Propranolol is a non-selective beta-adrenergic antagonist commonly used to manage hypertension, anxiety, and certain types of heart conditions. One of the critical effects of propranolol is its ability to decrease heart rate (bradycardia) by blocking beta-1 receptors in the heart. Therefore, it is essential to monitor heart rate closely when administering this medication.
In this scenario, the client’s pulse rate is 54 beats per minute, which is below the typical threshold for bradycardia (generally defined as a heart rate less than 60 beats per minute). This finding indicates that the client’s heart rate is significantly slowed, which could be dangerous, especially if the patient exhibits symptoms such as dizziness, weakness, or fainting. Bradycardia can lead to inadequate perfusion and oxygenation of vital organs, resulting in severe complications. Thus, it is prudent for the nurse to withhold propranolol in this case.
Other options are less critical in determining the need to withhold the medication:
- A. Blood pressure 156/90 mm Hg: While this blood pressure reading is elevated, it does not necessitate immediate withholding of propranolol. The medication may still be appropriate for managing hypertension.
- C. Potassium 5.2 mEq/L: This potassium level is within the normal range (typically 3.5 to 5.0 mEq/L), so it does not warrant withholding propranolol.
- D. Sodium 130 mEq/L: Although this sodium level indicates hyponatremia, it is not a direct contraindication for propranolol administration.
In conclusion, bradycardia is a significant and immediate concern when administering propranolol, making a pulse of 54/min the deciding factor for withholding the medication. Monitoring and evaluating the patient’s vital signs are essential components of safe nursing practice in this context.