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. Acetaminophen: Acetaminophen is an effective analgesic for mild to moderate pain but may not be sufficient for managing postoperative pain after a total knee arthroplasty, where moderate to severe pain is common.

B. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID. that can be used for pain, but it may not be the best choice for moderate to severe postoperative pain, as opioids are typically more effective for this type of pain.

C. Celecoxib: Celecoxib is an NSAID, and like ibuprofen, it can be useful for managing pain, but for a postoperative pain level of 6, a stronger medication like an opioid may be more appropriate.

D. Oxycodone: Oxycodone is an opioid analgesic, and it is typically used to manage moderate to severe pain, such as the pain a patient may experience after total knee arthroplasty. It would be the most appropriate choice for a pain level of 6 on a 0–10 scale.

A. Respiratory acidosis is incorrect. Chronic diarrhea typically leads to metabolic acidosis, not respiratory acidosis. Metabolic acidosis occurs due to the loss of bicarbonate through diarrhea, which affects the body’s acid-base balance.

B. Hypermagnesemia is incorrect. Chronic diarrhea is more likely to lead to hypomagnesemia due to the loss of electrolytes through frequent bowel movements, not an increase in magnesium levels.

C. Hypertension is incorrect. Chronic diarrhea generally leads to dehydration and hypotension due to fluid loss rather than high blood pressure.

D. Hypokalemia is correct. Chronic diarrhea causes significant potassium loss, which can result in hypokalemia (low potassium levels). Potassium is lost in the stool, and this depletion can lead to muscle weakness, arrhythmias, and other complications.