Which medications should a nurse hold when a client’s apical pulse is 35 bpm?

In this scenario, holding digoxin is appropriate when a client’s apical pulse is 35 bpm because digoxin is a cardiac glycoside that increases the force of heart contractions while also potentially slowing the heart rate. This means that when a patient's heart rate is already low (bradycardic), administering digoxin could further decrease the heart rate, leading to potentially dangerous consequences such as severe bradycardia or even heart block.

Monitoring the apical pulse is crucial, especially in individuals who are already at risk for arrhythmias or other cardiac issues. Typically, digoxin is contraindicated or requires reassessment of its use if the heart rate falls below certain thresholds, usually around 60 bpm, depending on the clinical guidelines in place for individual patients.

The other medications listed have different effects; for example, amlodipine is a calcium channel blocker that lowers blood pressure and does not directly influence heart rate to the same extent as digoxin. Furosemide is a diuretic that helps with fluid management but does not impact heart rate directly. Metoprolol, while a beta-blocker that can decrease heart rate, may be used with caution and would typically be evaluated on a case-by-case basis, considering