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: Increased respiratory rate is not a sign of adverse reaction to metoprolol, but rather a normal response to hypoxia or distress. Metoprolol is a betablocker that can lower the heart rate and blood pressure, but it does not affect the respiratory rate directly.

Choice B reason: Bronchodilation is not a sign of adverse reaction to metoprolol, but rather a desired effect of asthma medications such as betaagonists or anticholinergics. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can cause bronchoconstriction or narrowing of the airways. This is why metoprolol is contraindicated or used with caution in clients with asthma.

Choice C reason: Decreased sputum production is not a sign of adverse reaction to metoprolol, but rather a result of effective asthma management. Metoprolol is a betablocker that does not have any direct effect on the mucus secretion or inflammation in the lungs.

Choice D reason: Wheezing is a sign of adverse reaction to metoprolol, as it indicates bronchoconstriction or narrowing of the airways. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can reduce the bronchodilation effect of beta agonists or other asthma medications. This can worsen the asthma symptoms and cause wheezing, coughing, dyspnea, or chest tightness. The nurse should monitor the client for these signs and report them to the prescriber immediately.

Choice A reason: This is incorrect. Fluticasone is a corticosteroid that is used to treat asthma and allergic rhinitis. It does not affect the patient's ability to exercise or engage in strenuous activity. In fact, exercise can help improve lung function and reduce inflammation.

Choice B reason: This is incorrect. Fluticasone does not affect the patient's potassium levels. Potassium is an electrolyte that is important for the function of the heart, muscles, and nerves. Some medications, such as diuretics, can lower potassium levels and require the patient to eat potassium rich foods, such as bananas, potatoes, and tomatoes. Fluticasone is not one of them.

Choice C reason: This is correct. Fluticasone can cause hyperglycemia, which is high blood sugar. This can occur because corticosteroids can increase the production of glucose in the liver and reduce the sensitivity of the cells to insulin, the hormone that regulates blood sugar. Hyperglycemia can cause symptoms such as increased thirst, hunger, urination, fatigue, and blurred vision. The patient should monitor their blood sugar levels regularly and report any changes to their doctor.

Choice D reason: This is incorrect. Fluticasone does not affect the patient's digestion or appetite. It can be taken with or without food. There is no need to avoid eating for 4 hours after taking Fluticasone. However, the patient should rinse their mouth with water after using Fluticasone inhaler or nasal spray, as this can help prevent oral thrush, a fungal infection that can cause white patches, soreness, and bleeding in the mouth.