A nurse is monitoring a client taking metoprolol (Lopressor). If the client's BP is 122/78 mm/Hg and the AP is 58 beats/min, what should the nurse's action be?

In this scenario, the correct action is to withhold the medication due to the client's apical pulse (AP) being at 58 beats per minute. Metoprolol is a beta-blocker commonly used to treat hypertension and certain heart conditions. One of its effects is to lower heart rate. A pulse rate below 60 beats per minute is generally considered bradycardic, leading healthcare providers to reassess the appropriateness of administering this medication to reduce the risk of further decreasing the heart rate and potentially causing adverse effects.

Monitoring the client's blood pressure shows that it is within the normal range (122/78 mm Hg), but the crucial factor here is the low heart rate. By withholding the medication, the nurse prevents a potentially dangerous drop in the heart rate that could lead to inadequate cardiac output and symptoms of dizziness, fatigue, or more severe complications.

In situations like these, careful assessment of both blood pressure and heart rate is essential for safe medication administration, especially with medications that can influence cardiac function. Thus, prioritizing patient safety by withholding the medication aligns with best nursing practices.