An outpatient who has chronic heart failure returns to the clinic after 2 weeks of therapy with metoprolol (Toprol XL). Which assessment finding is most important for the nurse to report to the health care provider?
a. 2+ pedal edema
b. Heart rate of 56 beats/minute
c. Blood pressure (BP) of 88/42 mm Hg
d. Complaints of fatigue
ANS: C
The patient's BP indicates that the dose of metoprolol may need to be decreased because of hypotension. Bradycardia is a frequent adverse effect of ?-adrenergic blockade, but the rate of 56 is not unusual with รข-adrenergic blocker therapy. ?-Adrenergic blockade initially will worsen symptoms of heart failure in many patients, and patients should be taught that some increase in symptoms, such as fatigue and edema, is expected during the initiation of therapy with this class of drugs.
You might also like to view...
Labor contractions facilitate cervical dilation by:
a. Contracting the lower uterine segment. b. Enlarging the internal size of the uterus. c. Promoting blood flow to the cervix. d. Pulling the cervix over the fetus and amniotic sac.
________ is a refractory diuretic.
A. Acetazolamide B. Chlorothiazide C. Mannitol D. Isosorbide
With land priced much lower in rural areas than in urban areas, why don't companies build work places in rural areas where people are anxious to find full-time employment?
a. Employers need highly educated and skilled employees. b. Managers don't want to be transferred into a rural area where they won't fit in and won't be comfortable. c. Rural persons don't work as hard as urban dwellers. d. Smells emanating from farms are unacceptable to persons working inside.
On inspection of the external male genitalia, the nurse notes which finding as abnormal?
a. The scrotum is covered with dark rugous skin. b. The skin covering the penis is hairless and loose. c. The urinary meatus is located on the upper surface of the penis. d. The left side of the scrotum hangs slightly lower than the right.