A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D. In assessing the client prior to administering the medications

A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D.

In assessing the client prior to administering the medications, which of the following should the nurse report immediately to the health care provider?

• A. Blood pressure 94/60.
• B. Heart rate 76.
• C. Urine output 50 ml/hour.
• D. Respiratory rate 16.

Answer: A: Blood pressure 94/60

Both medications decrease the heart rate. Metoprolol affects blood pressure. Therefore, the heart rate and blood pressure must be within normal range (HR 60-100; systolic BP over 100) in order to safely administer both medications.