Before administering a client’s prescribed nonselective adrenergic blocker, what should the nurse assess?
A WBC count
B Pulse and blood pressure
C Bowel sounds
D Serum sodium and potassium levels
The Correct Answer and Explanation is:
Before administering a client’s prescribed nonselective adrenergic blocker, the nurse should assess the client’s pulse and blood pressure (B). Here’s why this assessment is crucial:
1. Understanding Nonselective Adrenergic Blockers:
Nonselective adrenergic blockers, such as propranolol, block both beta-1 and beta-2 adrenergic receptors. Beta-1 receptors are primarily located in the heart, while beta-2 receptors are found in various tissues including the lungs and blood vessels. By blocking these receptors, nonselective adrenergic blockers reduce heart rate and blood pressure, and can also influence bronchial smooth muscle tone.
2. Impact on Pulse and Blood Pressure:
Given that nonselective adrenergic blockers affect the heart’s rate and force of contraction, it is essential to monitor the client’s pulse and blood pressure before administration. These medications can lead to bradycardia (a slow heart rate) and hypotension (low blood pressure). Assessing these parameters ensures that the medication will not cause severe adverse effects in clients who may already be predisposed to these conditions.
- Pulse: Monitoring the pulse helps identify if the client has bradycardia or tachycardia (abnormally slow or fast heart rate), which could be exacerbated by the medication. For many nonselective adrenergic blockers, a pulse rate below 50 beats per minute is a contraindication for administration.
- Blood Pressure: Checking blood pressure is crucial to detect hypotension. Nonselective adrenergic blockers can lower blood pressure significantly, especially in patients with pre-existing hypertension or those taking other antihypertensive medications.
3. Why Other Assessments Are Less Relevant:
- WBC Count (A): While important for diagnosing infections and other conditions, it is not directly affected by nonselective adrenergic blockers.
- Bowel Sounds (C): These are relevant for gastrointestinal assessments, not typically impacted by nonselective adrenergic blockers.
- Serum Sodium and Potassium Levels (D): Although electrolyte imbalances can affect cardiovascular function, they are not the primary focus when initiating therapy with nonselective adrenergic blockers unless specifically indicated.
In summary, assessing pulse and blood pressure is vital to ensure the safe administration of nonselective adrenergic blockers, preventing potential complications associated with altered cardiovascular function.