The nurse is preparing to administer medications, including verapamil (Verelan), a calcium channel blocker, and metoprolol (Lopressor), a beta1-adrenergic blocker, to a client with hypertension
An entry in the client's medical record indicates he has developed AV block. Which action by the nurse is the most appropriate?
1. Administer both metoprolol (Lopressor) and verapamil (Verelan).
2. Hold both metoprolol (Lopressor) and verapamil (Verelan), and notify the prescriber.
3. Hold metoprolol (Lopressor), administer verapamil (Verelan), and notify the prescriber.
4. Hold verapamil (Verelan), administer metoprolol (Lopressor), and notify the prescriber.
Correct Answer: 2
Rationale 1: Administering both drugs could potentiate AV block in this client.
Rationale 2: Both drugs reduce conduction through the AV node and should be administered with caution to this client.
Rationale 3: Verapamil, a calcium channel blocker, mimics the action of the beta1-adrenergic blocker in blocking conduction through the AV node, and should not be administered to this client. Metoprolol, a beta1-adrenergic blocker, mimics the action of the calcium channel blocker verapamil in blocking conduction through the AV node, and should not be administered to this client.
Rationale 4: Both verapamil and metoprolol block conduction through the AV node, so neither drug should be administered to this client.
Global Rationale: Both drugs reduce conduction through the AV node and should be administered with caution to this client. Administering both drugs could potentiate AV block in this client. Verapamil, a calcium channel blocker, mimics the action of the beta1-adrenergic blocker in blocking conduction through the AV node, and should not be administered to this client. Metoprolol, a beta1-adrenergic blocker, mimics the action of the calcium channel blocker verapamil in blocking conduction through the AV node, and should not be administered to this client. Both verapamil and metoprolol block conduction through the AV node, so neither drug should be administered to this client.
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