A nurse is assessing a client who has heart failure and a new prescription for metoprolol. Which of the following findings should the nurse identify as an adverse effect of the medication?

Choice A reason: Including more cantaloupe in the diet is a good practice for a client on furosemide therapy. Cantaloupe is high in potassium, and furosemide can cause hypokalemia (low potassium levels) as it is a potent diuretic that increases urine production and the excretion of various electrolytes, including potassium. Therefore, consuming foods rich in potassium can help counteract this potential adverse effect.

Choice B reason: Checking the pulse before taking the medication is a general safety measure but does not directly relate to a specific adverse effect of furosemide. While it's important to monitor heart rate, especially in clients with heart failure, this statement does not reflect an understanding of the adverse effects related to furosemide.

Choice C reason: Trying to limit foods that contain salt is an appropriate action for a client with heart failure but is not directly related to an adverse effect of furosemide. Reducing salt intake can help manage heart failure by preventing fluid retention; however, it does not address the specific adverse effects of furosemide therapy.

Choice D reason: Checking blood pressure to ensure it doesn't get too high is important for clients with heart failure but does not indicate an understanding of the adverse effects of furosemide. Furosemide is used to reduce excess fluid in the body, which can lower blood pressure, not increase it. This statement does not reflect an understanding of furosemide's potential to cause electrolyte imbalances.

Choice A reason: Hypotension, or low blood pressure, is not typically associated with thyroid storm. Thyroid storm is a life-threatening condition that often presents with hypertensive crisis due to the excessive amount of thyroid hormones accelerating the body's metabolism.

Choice B reason: Increased temperature is a hallmark sign of thyroid storm. Patients experiencing a thyroid storm can have a high fever, with temperatures ranging from 104°F to 106°F. This is due to the hypermetabolic state induced by excessive thyroid hormones, which increases the body's heat production.

Choice C reason: Lethargy is not a common symptom of thyroid storm. Instead, patients may experience agitation, irritability, and anxiety due to the overstimulation of the nervous system by excessive thyroid hormones. Lethargy might be observed in hypothyroidism, which is the opposite condition.

Choice D reason: A decreased heart rate is not characteristic of thyroid storm. On the contrary, tachycardia, or a rapid heart rate, is a common symptom. The heart rate can exceed 140 beats per minute as the body's demand for oxygen increases due to the hypermetabolic state.