A nurse in a long-term care facility is contributing to the plan of care for a client who has a new prescription for propranolol. The nurse should plan to monitor the client for which of the following adverse effects of the medication?

A. Give a dose of alendronate is incorrect. Alendronate is a medication used to treat osteoporosis, and it does not address low potassium levels. In this case, the focus should be on correcting the potassium imbalance.

B. Administer furosemide is incorrect. Furosemide is a diuretic that can cause further loss of potassium. In a client with low potassium levels (hypokalemia., administering furosemide could worsen the condition and lead to life-threatening complications.

C. Apply a cardiac monitor is correct. Hypokalemia (potassium level of 2.9 mEq/L) can cause significant cardiac arrhythmias, including ventricular tachycardia or fibrillation. Applying a cardiac monitor is essential for monitoring the client’s heart rhythm and detecting any abnormalities related to the low potassium level.

D. Monitor for Chvostek's sign is incorrect. Chvostek's sign is indicative of hypocalcemia, not hypokalemia. While both hypocalcemia and hypokalemia can cause neuromuscular excitability, monitoring for Chvostek’s sign is not a priority in the management of hypokalemia.

A. The medication (erythromycin) is clearly identified in the prescription, so no clarification is needed regarding the drug name itself. B. The dosage (500 mg) is specified in the order, which is a standard dose for this medication, so it does not require clarification. C. The time or frequency is provided as “four times per day.” While specific facility times may need to be assigned, the frequency of administration is clearly established in the order. D. The route is entirely missing from the prescription. Erythromycin can be administered via several different routes, such as orally or intravenously, and the nurse cannot assume the intended method. This is a critical omission that must be clarified for safe transcription.