The nurse is caring for a patient with chronic heart failure who has been prescribed digoxin (Lanoxin). The patient’s apical pulse rate is 58 beats/min. What should the nurse do next?

This is because metoprolol is a beta blocker, which can block the beta-2 receptors in the lungs and cause constriction of the airways.This can lead to breathing problems such as shortness of breath, cough, and wheezing. Bronchospasm is more likely to occur in people who have asthma or chronic obstructive pulmonary disease (COPD).

Choice A is wrong because tachycardia, or fast heart rate, is not an adverse effect of metoprolol. In fact, metoprolol can lower the heart rate by blocking the beta-1 receptors in the heart.A normal resting heart rate for adults ranges from 60 to 100 beats per minute (bpm).Metoprolol can cause bradycardia, or slow heart rate, which can be a serious side effect if it is too low.

Choice B is wrong because hyperglycemia, or high blood sugar, is not an adverse effect of metoprolol. Metoprolol does not affect the insulin secretion or glucose metabolism in the body.A normal blood sugar level for adults without diabetes is less than 140 mg/dL (7.8 mmol/L) two hours after eating. Metoprolol can cause hypoglycemia, or low blood sugar, in people who have diabetes and take insulin or other glucose-lowering medications.This is because metoprolol can mask the symptoms of hypoglycemia, such as palpitations and tremors.

Choice D is wrong because hyperkalemia, or high potassium, is not an adverse effect of metoprolol. Metoprolol does not affect the potassium balance in the body.

A normal blood potassium level for adults is 3.6 to 5.2 millimoles per liter (mmol/L)

The nurse should advise the patient with heart failure to limit or avoid canned soups and sauces because they are high in sodium, which can cause fluid retention and worsen cardiac function.Sodium intake should be restricted to less than 2 g per day for patients with heart failure.

Choice A is wrong because fresh fruits and vegetables are good sources of potassium, magnesium, and fiber, which are beneficial for heart health.Potassium and magnesium help regulate fluid and electrolyte balance, and fiber helps lower cholesterol and blood pressure.

Choice B is wrong because whole grains and cereals are also rich in fiber, as well as complex carbohydrates, which provide energy and prevent rapid fluctuations in blood glucose levels.Whole grains and cereals may also contain phytochemicals that have antioxidant and anti-inflammatory effects.

Choice C is wrong because lean meats and poultry are low in saturated fat and cholesterol, which can contribute to atherosclerosis and coronary artery disease. Lean meats and poultry provide protein, which is essential for tissue repair and wound healing.Protein intake should be adequate but not excessive for patients with heart failure, as too much protein can increase the workload of the kidneys.