A patient on beta-blockers for CAD reports fatigue and cold extremities. What is the most appropriate nursing action?

Choice A rationale Discontinuing the medication should never be a unilateral nursing decision, as beta-blockers must be tapered off gradually to prevent rebound hypertension, reflex tachycardia, or an acute myocardial infarction. Abrupt cessation can cause a sudden increase in heart rate and blood pressure, putting the patient at significant risk. Choice B rationale Fatigue and cold extremities are recognized side effects of beta-blockers, which work by blocking beta-adrenergic receptors, leading to decreased heart rate and vasodilation. Assessing vital signs, especially heart rate and blood pressure, helps determine the severity of the symptoms and whether the medication's therapeutic effects are too pronounced, warranting a dose adjustment by the provider. Choice C rationale Increasing the dose would likely worsen the patient's fatigue and cold extremities. These symptoms are dose-dependent effects of beta-blockers, and a higher dose would intensify the medication's physiological impact, leading to a more pronounced decrease in cardiac output and peripheral circulation, exacerbating the patient's discomfort. Choice D rationale While rest may provide temporary relief for fatigue, it does not address the underlying pharmacological cause of the symptoms. The patient's fatigue is a direct result of the medication's effect on heart rate and cardiac output. The more appropriate nursing action is to report the findings to the provider for a potential medication or dose change.