Question

A nurse is about to administer Propanolol to a patient. The nurse takes the patient's apical pulse and documents it as 58 bmp. How should the nurse continue?

a. Administer the medication as normal
b. Cut the tablet in half and administer half of the normal dose c. Give the XR form of the medication
d. Withhold administration of the medication and notify physician

Answer 1

The nurse should withhold administration of Propranolol when the patient's apical pulse is 58 bmp and promptly notify the physician, due to the risk of exacerbated bradycardia.

Step-by-step explanation:

When a nurse assesses a patient's apical pulse and finds it to be at 58 beats per minute, the nurse must consider the medication being administered and the clinical context. Propranolol is a beta-blocker medication used in the treatment of hypertension, and works by binding to beta-1 receptors, which can slow the heart rate. Given that beta-blockers can lead to bradycardia, a condition where the heart rate is slower than normal, it's important to avoid overprescribing or giving such medication when the heart rate is already low.

In this instance, with an apical pulse of 58 bmp, which is on the lower limit of normal, the nurse should withhold administration of the medication and notify the physician. The decision to withhold the dose is based on best practice in patient safety, as administering the medication could potentially exacerbate bradycardia and lead to adverse effects.