A patient has recently started ferrous sulfate 500 mg by mouth two times per day for anemia. Which of the following data would indicate to the nurse that the therapy is successful?

Choice A reason: Throwing away any tablets that fizzle under my tongue, it means they are ineffective is not a statement that indicates an understanding of the discharge teaching. This statement is incorrect and dangerous, as fizzling or tingling is a normal sensation that indicates that the tablet is working. The client should not discard or waste the medication, but keep it in a dark, dry, and cool place.

Choice B reason: Keeping my bottle of nitroglycerin at home in the medicine cabinet is not a statement that indicates an understanding of the discharge teaching. This statement is impractical and risky, as the client may need the medication when they are away from home. The client should always carry the medication with them and have it readily available in case of chest pain.

Choice C reason: Calling 911 if I get chest pain that doesn't go away after one tablet and I will take another tablet is a statement that indicates an understanding of the discharge teaching. This statement is correct and safe, as it follows the standard protocol for using nitroglycerin SL for angina. The client should take one tablet under the tongue at the onset of chest pain, wait five minutes, and repeat if the pain persists. If the pain is not relieved after three tablets, the client should seek emergency medical attention.

Choice D reason: Removing the tablets from the bottle and keeping them in a plastic bag in my handbag is not a statement that indicates an understanding of the discharge teaching. This statement is inappropriate and harmful, as it exposes the medication to light, moisture, and heat, which can reduce its potency and effectiveness. The client should keep the tablets in their original container and close it tightly after each use.

Choice A reason: Placing the call bell in reach of the client is the most appropriate nursing action following the administration of metoprolol, a beta-blocker that lowers blood pressure and heart rate. ¹ The client may experience dizziness, lightheadedness, or fainting as side effects of the medication, especially after the first dose. ² The call bell allows the client to alert the nurse if they need assistance or experience any adverse reactions.

Choice B reason: Taking a pulse oximetry reading is not the most appropriate nursing action following the administration of metoprolol. Pulse oximetry measures the oxygen saturation of the blood, which is not directly affected by metoprolol. ³ A more relevant vital sign to monitor is the blood pressure and heart rate, which can indicate the effectiveness and safety of the medication.

Choice C reason: Recording the client's weight is not the most appropriate nursing action following the administration of metoprolol. Weight is not a sensitive indicator of the immediate effects of metoprolol. Weight may be monitored periodically to assess the client's fluid status and possible signs of heart failure, which metoprolol can help prevent. ¹ However, this is not a priority action after the first dose of the medication.

Choice D reason: Encouraging oral fluids is not the most appropriate nursing action following the administration of metoprolol. Oral fluids may help prevent dehydration and constipation, which can occur as side effects of metoprolol. ² However, excessive fluid intake may worsen the client's blood pressure and heart function, which metoprolol aims to improve. The nurse should advise the client to drink fluids as directed by the provider and report any signs of fluid overload, such as swelling, shortness of breath, or weight gain.