رجل عمره ٦١ سنة في اليوم الثاني بعد احتشاء قلبي، موصوف له ميتوبرولول ٥٠ ملغ بالفم صباحاً. قبل الجرعة: النبض ٥٤ منتظم، والضغط ٩٨/٦٠، والتنفس ١٦، والمريض جالس ويقرأ بلا دوخة أو ألم. ما التصرف الصحيح؟

A 61-year-old man on day 2 after a myocardial infarction is prescribed metoprolol 50 mg orally each morning. Before the dose: HR 54 regular, BP 98/60, RR 16; he is sitting reading with no dizziness or pain. What is the correct action?

1. Hold the dose and report the readings to the provider
2. Give half the dose because the client has no symptoms
3. Give the full dose and recheck vital signs in an hour
4. Give the dose with food to soften its effect on the pulse

Answer: A) Hold the dose and report the readings to the provider. Beta-blockers slow the heart and lower BP; the usual rule is to hold them if the pulse is under 60 or systolic under 100 unless the provider sets other limits. The nurse does not change the dose on her own, and food does not prevent the effect.