A nurse is caring for a client with asthma who is prescribed metoprolol. The nurse should monitor the client for which of the following?

Choice A reason: Bradycardia is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the heart rate or blood pressure significantly, and it is not associated with bradycardia, which is a slow heart rate that can cause dizziness, fatigue, or fainting. The nurse should monitor the vital signs of the client after administering diphenhydramine, but bradycardia is not a common or expected outcome.

Choice B reason: Sedation is an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine can cross the bloodbrain barrier and block the histamine receptors in the brain, which are involved in regulating the sleepwake cycle and alertness. Diphenhydramine can cause sedation, sleepiness, drowsiness, dizziness, and impaired coordination, which can affect the performance and safety of the client. The nurse should instruct the client to avoid driving, operating machinery, or performing other tasks that require mental alertness after taking diphenhydramine, and to take the medication at bedtime or as needed for sleep.

Choice C reason: Constipation is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the gastrointestinal motility or secretion significantly, and it is not associated with constipation, which is a condition of infrequent or difficult bowel movements. The nurse should encourage the client to eat a balanced and highfiber diet, drink plenty of fluids, and exercise regularly to prevent or treat constipation, but diphenhydramine is not a contributing factor.

Choice D reason: Hypertension is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the blood pressure or the vascular tone significantly, and it is not associated with hypertension, which is a condition of high blood pressure that can cause headaches, chest pain, or stroke. The nurse should monitor the blood pressure of the client after administering diphenhydramine, but hypertension is not a common or expected outcome.

Choice A reason: Serum potassium level of 5.5 mEq/L is above the normal range of 3.55.0 mEq/L, but it is not a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can also cause the loss of potassium in the urine, which can lead to hypokalemia, a condition that causes muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should monitor the serum potassium level and administer potassium supplements or potassium sparing diuretics as prescribed to prevent hypokalemia.

Choice B reason: Blood pressure of 130/80 mmHg is slightly above the normal range of 120/80 mmHg, but it is not a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can reduce the fluid volume and the peripheral resistance, which can lower the blood pressure and prevent or treat hypertension, edema, or heart failure. The nurse should monitor the blood pressure regularly and adjust the dose of Lasix as prescribed to maintain a normal blood pressure.

Choice C reason: Serum potassium level of 3.0 mEq/L is below the normal range of 3.55.0 mEq/L, and it is a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can also cause the loss of potassium in the urine, which can lead to hypokalemia, a condition that causes muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should notify the health care provider immediately and prepare to administer interventions such as potassium supplements or potassium sparing diuretics to correct hypokalemia.

Choice D reason: Serum sodium level of 140 mEq/L is within the normal range of 135145 mEq/L, and it is not a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can cause the loss of sodium in the urine, which can lead to hyponatremia, a condition that causes confusion, seizures, coma, or death. The nurse should monitor the serum sodium level and administer sodium supplements or fluids as prescribed to prevent hyponatremia.