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: “This medication should be taken after eating to reduce nausea.” is not a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron can be taken with or without food, and it does not affect the digestion or absorption of food. Ondansetron is usually taken before the start of chemotherapy, radiation, or surgery, which are the common causes of nausea and vomiting.

Choice B reason: “This medication should not be taken with starfruit.” is not a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron does not interact with starfruit, which is a tropical fruit that contains substances that can inhibit the enzyme CYP3A4, which is involved in the metabolism of many drugs. Ondansetron is mainly metabolized by another enzyme, CYP1A2, and it has a low potential for drug interactions¹.

Choice C reason: “This medication may make me tired and confused.” is a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron can also cross the blood brain barrier and affect other serotonin receptors in the brain, which are involved in regulating mood, cognition, and sleep. Ondansetron can cause side effects such as fatigue, drowsiness, headache, and confusion, which can impair the mental alertness and performance of the client. The client should be advised to avoid driving, operating machinery, or doing other tasks that require attention after taking ondansetron.

Choice D reason: “This medication may cause rebound nausea.” is not a correct statement that demonstrates understanding about ondansetron. Ondansetron is a medication that prevents nausea and vomiting by blocking the action of serotonin, a chemical that stimulates the vomiting center in the brain. Ondansetron does not cause rebound nausea, which is a condition of nausea that occurs after the discontinuation of a medication that suppresses nausea. Ondansetron is not a medication that suppresses nausea, but rather prevents it by blocking the stimulation of the vomiting center. Ondansetron does not cause dependence or withdrawal symptoms, and it can be stopped without causing rebound nausea.

Choice A reason: "I am not ready to eat lunch yet." is not a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma¹. Albuterol does not affect the appetite or the digestion directly, but it may cause some side effects such as nausea, vomiting, or dry mouth, which may reduce the desire to eat. The nurse should respect the patient's preference and offer them food later when they are ready.

Choice B reason: "It feels like my heart is racing." is a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, but it also stimulates the beta receptors in the heart, which can increase the heart rate and the blood pressure¹. This can cause side effects such as palpitations, chest pain, or arrhythmias, especially in patients with underlying heart conditions or those who take other medications that affect the heart. The nurse should monitor the patient's vital signs, report the finding to the prescriber, and prepare to administer interventions such as betablockers or calcium channel blockers to lower the heart rate and prevent complications.

Choice C reason: "It is easier to breathe now." is not a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma¹. This is the expected and desired outcome of the Albuterol nebulizer treatment, which indicates that the medication is effective and the patient is responding well. The nurse should document the patient's response and continue to assess the patient's respiratory status and oxygen saturation.

Choice D reason: "I can breathe better now." is not a concerning statement for the patient who has completed their Albuterol nebulizer treatment. Albuterol is a medication that relaxes the muscles in the airways and increases the airflow to the lungs, which can improve the breathing and reduce the wheezing in patients with asthma¹. This is the expected and desired outcome of the Albuterol nebulizer treatment, which indicates that the medication is effective and the patient is responding well. The nurse should document the patient's response and continue to assess the patient's respiratory status and oxygen saturation.