Failure to Obtain Physician-Ordered Blood Pressure Parameters for Antihypertensive Medication
Penalty
Summary
The facility failed to obtain physician-ordered blood pressure parameters for a resident receiving metoprolol to treat hypertension. The resident had a medical history including hypertension, occlusion and stenosis of the right carotid artery, and occlusion and stenosis of the right posterior cerebral artery. The resident was cognitively intact, independent with activities of daily living, and did not ambulate. The care plan directed staff to monitor and report signs and symptoms of malignant hypertension and to administer medication as ordered. However, the physician's order for metoprolol did not specify blood pressure parameters, and this omission was confirmed by both a licensed nurse and an administrative nurse during interviews. The facility's policy required staff to document vital signs and recognize significant changes in blood pressure, reporting symptoms such as lightheadedness, dizziness, blurred vision, or shallow breathing. Despite this, the lack of specific physician-ordered parameters for blood pressure monitoring in relation to the administration of metoprolol represented a failure to ensure the resident's drug regimen was free from unnecessary drugs and that medications were administered safely according to physician guidance.