A nurse is preparing to administer the first 5 mg dose of metoprolol (Toprol) to a patient who is 12 hours post MI. For which assessment finding should the nurse withhold administration of the medication?
1. Serum potassium 3.9 mEq/L
2. Blood pressure of 110/65 mm Hg
3. PR interval 0.12 second
4. Sinus bradycardia 52 beats per minute
4
Rationale 1: The medication would not need to be withheld for this laboratory value.
Rationale 2: The medication can be given with this blood pressure.
Rationale 3: This medication can be given with this PR interval.
Rationale 4: Beta blocker therapy is contraindicated when the patient has a heart rate less than 60 beats per minute, systolic blood pressure less than 100 mm Hg, moderate or severe left ventricular failure, shock, PR interval on the electrocardiogram greater than 0.24 second, second- and third-degree heart block, and active asthma and/or reactive airway disease.
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