Two primary nursing considerations when starting a beta-blocker and a key contraindication are which of the following?

Two primary nursing considerations when starting a beta-blocker and a key contraindication are which of the following?

• A. Monitor respiratory rate and oxygen saturation; contraindicated in tachycardia.
• B. Monitor weight and appetite; contraindicated in uncontrolled diabetes.
• C. Monitor liver enzymes and bilirubin; contraindicated in kidney failure.
• D. Monitor heart rate and blood pressure; watch for bradycardia, hypotension, and bronchospasm in nonselective agents; contraindicated in sinus bradycardia, second/third-degree AV block, and uncontrolled asthma/COPD.

Answer: (D)

Starting a beta-blocker requires careful assessment of heart rate and blood pressure because these drugs slow the heart and lower blood pressure. You monitor heart rate and blood pressure before and after starting, and you adjust or hold therapy if the heart rate is too low or the blood pressure drops. Nonselective beta-blockers block both beta-1 receptors in the heart and beta-2 receptors in the lungs, which can lead to bronchospasm. This is why they are contraindicated in patients with uncontrolled asthma or COPD. The combination of potential bradycardia, hypotension, and bronchospasm makes the listed contraindications especially important: sinus bradycardia, second- or third-degree AV block, and uncontrolled asthma or COPD. Other options aren’t the primary nursing focus for initiating beta-blockers. Monitoring weight or appetite, liver enzymes, or other noncardiovascular labs aren’t the critical safety checks for starting these drugs, and tachycardia isn’t a contraindication though it would be monitored as the drug exerts its effect.

Starting a beta-blocker requires careful assessment of heart rate and blood pressure because these drugs slow the heart and lower blood pressure. You monitor heart rate and blood pressure before and after starting, and you adjust or hold therapy if the heart rate is too low or the blood pressure drops.

Nonselective beta-blockers block both beta-1 receptors in the heart and beta-2 receptors in the lungs, which can lead to bronchospasm. This is why they are contraindicated in patients with uncontrolled asthma or COPD. The combination of potential bradycardia, hypotension, and bronchospasm makes the listed contraindications especially important: sinus bradycardia, second- or third-degree AV block, and uncontrolled asthma or COPD.

Other options aren’t the primary nursing focus for initiating beta-blockers. Monitoring weight or appetite, liver enzymes, or other noncardiovascular labs aren’t the critical safety checks for starting these drugs, and tachycardia isn’t a contraindication though it would be monitored as the drug exerts its effect.