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A nurse is caring for a client in a provider's office.

Click to highlight the findings that indicate an adverse effect of the medication. To deselect a finding, click on the finding again.

Nurses' Notes

Today:

Client returns for follow-up visit after starting labetalol. Client reports feeling more tired since starting the medication and is having trouble sleeping. Client states, "I have also had loose stools several times this week and often get dizzy whenever I stand up."

Vital Signs

Today:

Temperature 37° C (98.6° F)

Heart rate 56/min

Respiratory rate 14/min

Blood pressure 118/76 mm Hg

Client returns for follow-up visit after starting labetalol

Client reports feeling more tired since starting the medication

Client states, "I have also had loose stools several times this week and often get dizzy whenever I stand up."

Heart rate 76/min

Heart rate 56/min

and is having trouble sleeping

Answer and Explanation

The Correct Answer is ["B","C","E","F"]

Feeling more tired since starting the medication: Fatigue is a common adverse effect of beta-blockers like labetalol because they reduce heart rate and cardiac output. This decrease in cardiac output can limit blood flow to muscles and organs, contributing to generalized tiredness.
Trouble sleeping: Beta-blockers can interfere with normal sleep patterns by decreasing melatonin secretion and altering sympathetic nervous system activity. Clients may experience difficulty falling asleep or frequent awakenings during the night.
Dizziness when standing up (orthostatic hypotension): Labetalol’s alpha- and beta-blocking effects can reduce vascular resistance and blood pressure. When the client stands, the drop in blood pressure can cause lightheadedness or dizziness, especially in the first days of therapy.
Heart rate 56/min (bradycardia): Beta-blockers slow the heart rate by decreasing sympathetic stimulation of the SA node. A heart rate below 60/min is considered bradycardia and may lead to fatigue, dizziness, or fainting.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Increase in urine output: An increase in urine output indicates that the kidneys are adequately perfused and that intravascular volume has improved. This is a primary indicator that fluid replacement therapy is effective in correcting fluid volume deficit.

B. Decrease in dependent edema: Dependent edema reflects fluid overload rather than deficit. A decrease in edema would not indicate successful treatment of fluid volume deficit and is not a relevant marker in this scenario.

C. Increase in heart rate: Tachycardia is often a compensatory response to fluid volume deficit. An increase in heart rate would suggest ongoing hypovolemia rather than improvement.

D. Decrease in blood pressure: Hypotension is typically associated with fluid volume deficit. A further decrease in blood pressure would indicate worsening fluid status, not effective therapy.

A. Increased bowel sounds B. Dark amber urine C. Shortness of breath D. Decreased skin turgor

Correct Answer is C

Explanation

A. Increased bowel sounds: Increased bowel sounds are not associated with IV fluid therapy. They typically occur with gastrointestinal stimulation or diarrhea, not with excessive fluid administration.

B. Dark amber urine: Dark urine indicates concentrated urine and dehydration, suggesting that the client may still be underhydrated rather than experiencing an adverse effect of fluid infusion.

C. Shortness of breath: Shortness of breath can indicate fluid volume overload, an adverse effect of rapid or excessive infusion of 0.9% sodium chloride. The fluid may accumulate in the lungs, leading to pulmonary edema and impaired gas exchange.

D. Decreased skin turgor: Decreased skin turgor is a sign of dehydration, which should improve—not worsen—during IV fluid therapy. Its presence would suggest inadequate fluid replacement rather than an adverse effect.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has fluid volume deficit and is receiving intermittent IV fluid replacement therapy. Which of the following findings should the nurse identify as an indication the treatment has been effective?

Correct Answer is A

Explanation

A nurse is caring for a client who is receiving 0.9% sodium chloride solution to treat dehydration. Which of the following findings should the identify as an adverse effect of the infusion?

Correct Answer is C

Explanation

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