Failure to Follow Physician Parameters for Antihypertensive Medication Administration
Penalty
Summary
The facility failed to ensure that a resident's antihypertensive medication, Metoprolol, was administered according to the physician's ordered parameters. The physician's order specified that Metoprolol 25 mg should be held if the resident's systolic blood pressure was less than 110 or if the heart rate was less than 60. Despite these instructions, the medication was administered on multiple occasions when the resident's pulse was below 60, including documented instances where the pulse was 58, 57, 52, 55, and 59. The resident had a medical history that included dysphagia, aphasia, dysarthria, atrial septal defect, asthma, atrial fibrillation, hypertensive urgency, hypertensive heart disease with heart failure, obesity, heart failure, and hyperlipidemia. The Regional Nurse confirmed that the medication was given outside the prescribed parameters.