A patient is receiving an IV medication that must be titrated according to heart rate. The prescriber's order reads: "Adjust the infusion rate if the patient's heart rate drops below 60 beats per minute (bpm) or rises above 100 bpm." During assessment, the nurse notes a heart rate of 58 bpm. What action should the nurse take first?
Increase the infusion rate to counteract the low heart rate
Maintain the current infusion rate and reassess in 30 minutes
Reduce the infusion rate as directed in the order
Stop the infusion immediately and notify the provider
Because the heart rate is below the ordered threshold, the nurse should immediately reduce the infusion rate as directed. This follows the titration parameters and helps prevent further bradycardia. Increasing the rate would likely worsen the bradycardia, keeping it unchanged ignores the order, and stopping the infusion and calling the provider is unnecessary unless additional signs of instability are present.
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