| Course | NR 293 Pharmacology for Nursing Practice |
|---|---|
| Week | 5 |
| Paper type | Drug class write-up |
| Length | About 1,190 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 293 Week 5
Drug Class Write-Up: Beta-Blockers, From the Tablet at Breakfast to the Infusion in the Emergency Department, Sorted by What Changes the Nurse's Work
Student Name
College of Nursing, Chamberlain University
NR 293: Pharmacology for Nursing Practice
Instructor Name
Month Day, Year
Drug Class Write-Up: Beta-Blockers, From the Tablet at Breakfast to the Infusion in the Emergency Department, Sorted by What Changes the Nurse's Work
Mechanism, Only as Far as It Earns
Beta-blockers occupy beta-adrenergic receptors so that adrenaline and noradrenaline act on them less. At beta-1 receptors in the heart, the result is a slower rate, a less forceful beat and slower conduction through the node between the upper and lower chambers. At beta-2 receptors in the airways and elsewhere, blocking can narrow the airways and blunt some of the body's responses to low blood sugar. Those two sentences are all the mechanism the nurse needs, because each one becomes a check: the heart rate and blood pressure before the dose, breathing in patients with lung disease, and blood sugar awareness in patients with diabetes.
Members, Separated by Nursing Work
Table 1 sorts the common members by the differences that change what the nurse does, not by chemical structure.
Table 1
Beta-Blockers Sorted by the Nurse's Work
| Member | Route and timing | Receptor selectivity | What it changes for the nurse |
|---|---|---|---|
| Metoprolol tartrate | By mouth twice daily; also IV push | Mostly beta-1 | Short-acting; missed or held doses show quickly in heart rate |
| Metoprolol succinate | By mouth once daily, extended release | Mostly beta-1 | Not to be crushed; not interchangeable dose-for-dose with tartrate without an order |
| Carvedilol | By mouth twice daily with food | Beta-1, beta-2 and alpha-1 | More blood pressure lowering and dizziness on standing; given with food |
| Propranolol | By mouth several times daily or long-acting | Beta-1 and beta-2 | Most likely to cause wheeze; used for tremor and some migraines |
| Esmolol | IV infusion only | Beta-1 | Acts within minutes and wears off within minutes; titrated at the pump with continuous monitoring |
Note. Selectivity is relative; at higher doses, beta-1-selective agents also affect beta-2 receptors.
The row most often misunderstood is the pair of metoprolols. Metoprolol succinate, the once-daily extended-release form, is one of the three beta-blockers shown to reduce mortality in heart failure with reduced ejection fraction, together with carvedilol and bisoprolol, and the heart failure guideline recommends one of these three rather than any beta-blocker (Heidenreich et al., 2022). A patient admitted on metoprolol succinate for heart failure who is switched to tartrate for convenience has not received the same treatment. The nurse notices this at reconciliation and asks.
The Before Block
Before each oral dose, the nurse checks:
Apical or monitored heart rate: hold and call if below the order's parameter, commonly 50 or 60 a minute, or if a new heart block appears on the monitor.
Blood pressure: hold and call if systolic is below the order's parameter, commonly 90 to 100.
Breathing, in patients with asthma or COPD: new wheeze or shortness of breath is reported before the next dose.
Glucose awareness, in patients with diabetes: beta-blockers can hide the fast heartbeat and tremor of low blood sugar, although sweating is usually preserved, so the patient is taught that sweating or confusion may be the first sign.
Signs of worsening heart failure, when a dose is increased: weight, swelling and breathlessness, because a higher dose can briefly worsen fluid retention before it helps.
Adverse Effects, Ranked, With Responses
1. Slow heart rate and heart block: hold the next dose, check the rhythm, call the provider; symptomatic slow rates may need atropine or pacing under the provider's direction.
2. Low blood pressure and dizziness on standing: hold if below parameters; teach to rise slowly; check for other blood pressure medicines given at the same time.
3. Bronchospasm: stop the drug and call; a bronchodilator may be ordered.
4. Fatigue and exercise intolerance: common early; reassure, report if severe.
5. Rebound if stopped suddenly: fast heart rate, high blood pressure and, in patients with coronary disease, chest pain; the nurse teaches patients never to stop the drug on their own and checks that it is not simply omitted at discharge.
One Patient, Three Members
The differences in Table 1 are easiest to see in a single patient moving through a hospital stay. Mr. J., 70, with coronary disease and atrial fibrillation, arrives in the emergency department with a heart rate of 150. He is given IV metoprolol tartrate in small repeated doses while on a monitor, because its effect is quick and can be judged within minutes. When his rate is still hard to control and his blood pressure drops, the provider switches to an esmolol infusion, which the nurse titrates at the pump every few minutes against the monitor, knowing that if his pressure falls the effect will fade soon after the infusion is slowed. On the medical unit the next day, he is converted to oral metoprolol tartrate twice daily, and at discharge, once his dose is settled, to metoprolol succinate once daily for convenience.
Each switch changes the nurse's work. The IV doses need the monitor on and the heart rate watched after each push. The infusion needs continuous monitoring and a pump with the concentration set correctly. The twice-daily tablets need a heart rate and blood pressure check before each dose, and the once-daily tablet needs the teaching that it should be swallowed whole and not stopped suddenly. The drug is the same class throughout; the work is different at each stage, which is why the class is taught by nursing work rather than by chemistry.
The Reversal, and Where It Lives
There is no single antidote kept for beta-blockers, but the treatments for serious effects are known and have a place. Atropine for symptomatic slow heart rate is in the code cart on every unit. Glucagon, which raises heart rate and contraction by a pathway that bypasses the blocked receptors, is used for severe beta-blocker overdose; on this hospital's units it is kept in the automated cabinet for hypoglycemia, in doses too small for overdose, and larger amounts come from pharmacy on request, which means calling early rather than when the patient is already in shock. For esmolol, the reversal is simply stopping the infusion, because its effect fades within minutes, which is one reason it is chosen when fine control is needed. Knowing where each of these lives before it is needed is part of giving the class safely.
What the Patient Takes Home
At discharge, the teaching for any oral beta-blocker comes down to four points: take it at the same time each day; do not stop it suddenly, even if you feel well; check your pulse if you have been taught how and call if it is below the number your provider gave you or if you feel faint; and, if you have diabetes, know that sweating or confusion may be the first sign of low blood sugar, because the racing heart may not come. The nurse confirms each point by asking the patient to say it back and by watching the patient count a pulse for thirty seconds.
References
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., . . . Yancy, C. W. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. https://doi.org/10.1161/CIR.0000000000001063
Reading the NR 293 Week 5 instructions
For Week 5 you write about one drug class, covering how it works, its main members, indications, adverse effects, nursing assessments and patient teaching. Expect the instructions to name the class or let you choose, and to ask for APA with drug references or guidelines. Mechanism matters only as far as it explains what the nurse checks. Members should be compared by differences that change nursing work, such as route, timing and selectivity, not by chemical structure. Adverse effects should be ranked, each with a response. Stopping values need numbers. Teaching should be brief and practical. Interactions belong when they change what the nurse does. Name the members you choose and why they were chosen.
How the NR 293 Week 5 example is put together
The write-up opens with mechanism in one paragraph: beta-1 effects on rate and conduction and beta-2 effects on airways. Table 1 sorts the common members by route, selectivity and what each changes for the nurse, and the text explains why the two metoprolols are not interchangeable, citing Heidenreich et al. (2022) on heart failure. A before block lists checks with thresholds: heart rate, blood pressure, breathing in lung disease, glucose awareness and heart failure signs. Five adverse effects are ranked with responses. One patient, Mr. J., moves from IV metoprolol to an infusion to tablets. A section explains reversal agents and where they are stored. Discharge teaching closes it.
Where the points sit in the NR 293 Week 5 rubric
Drug class rubrics generally grade accurate mechanism and indications, comparison of members, nursing assessments and parameters, adverse effects and interventions, teaching and APA. Assessments and adverse effects carry the most weight, so the before block turns mechanism into numbered checks and the ranked list pairs each effect with an action. Comparison earns credit when differences matter at the bedside, as with tartrate and succinate. Accuracy depends on current guideline evidence for which members reduce mortality. The one-patient walk-through shows application. Teaching scores when limited to what the patient can do. Placing the reversal treatments in the code cart and pharmacy shows practical knowledge. Accurate, current references round out the grade.
Common NR 293 Week 5 mistakes, and how to avoid them
Mechanism written at essay length is the classic loss here, crowding out the assessment section where points live. A member list with no bedside differences shows copying. Fourteen unranked adverse effects show reading, not understanding. Stopping values written as words instead of numbers, expected effects with no timing, interactions copied wholesale and missing teaching all cost marks. Three to five members are usually enough. Interactions belong when they change a nursing check. Graduate pharmacology goes deeper into prescribing; this course stays with the nurse. Name the class you were assigned, and the desk can draft a write-up sorted by what changes your work. Keep the before block short enough to use at a cart.
Get a NR 293 Week 5 example written to your instructions
Send the class your week covers, the prompt and the rubric if there is one, and a worked example comes back inside 24-48h with the first one free. Tell us whether your section wants a table or continuous prose, and whether a particular patient is attached to the class, since both change how much of the document goes to the before block.
More NR 293 papers and pre-licensure samples
- NR 293 Week 1: Nurse's Medication Responsibility Post
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- NR 293 Week 4: Medication Error Safety Analysis
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- NR 293 Week 7: Patient Teaching Script
- NR 293 Week 8: Medication Care Plan
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- NR 228 Week 5: Heart Failure Diet Write-Up
NR 293 Week 5 questions, answered
How many members of the class should I cover?
Enough to show the family resembles itself and differs where it matters, which is usually three or four. Prompts sometimes name the members, in which case that list settles it. Where they do not, choose ones a nurse actually meets, and separate them on route, speed or the monitoring they need rather than on structural chemistry nobody checks before a dose.
Do interactions belong in a class write-up?
The ones that change what you do, yes. An interaction that alters a stopping value, adds an observation or requires doses to be separated in time is nursing content and earns its space. A general list imported from a reference is not, because a grader cannot tell whether you selected it or copied it. Two or three, each with the consequence written out, reads far stronger.
Is this the same as the class work in graduate pharmacology?
It shares vocabulary and almost nothing else. Later coursework uses a class to decide which agent a patient should receive, comparing members against each other before anything is ordered. Here the order exists, the class has already been picked, and the write-up is measured on whether you can turn what the class does into checks, timings and teaching for the person receiving it.
Where can I find a free NR 293 Week 5 sample paper?
The complete Week 5 beta-blocker class write-up, with the member table, the before block, ranked adverse effects and one patient across three members, is printed here.
Why aren't the two metoprolols interchangeable in the NR 293 Week 5 example?
Metoprolol succinate is the once-daily extended-release form shown to reduce heart failure mortality, while tartrate is short-acting and twice daily, so they are not swapped dose for dose.