A client is receiving furosemide (Lasix). The nurse should monitor for which adverse effect of the medication?

A. Administer a rapid acting insulin: Giving additional insulin would worsen hypoglycemia and could lead to serious complications. The patient’s symptoms suggest low blood glucose, so administering more insulin is unsafe and not indicated at this time.

B. Perform bedside glucose testing.: Checking the patient’s blood glucose provides objective data to confirm hypoglycemia. This allows the nurse to determine the appropriate intervention, such as administering glucose orally or intravenously, ensuring safe and targeted treatment.

C. Notify the kitchen to deliver the tray.: While providing food is important, waiting for the tray without confirming blood glucose could delay treatment of hypoglycemia. Immediate assessment of glucose is required before feeding.

D. Give the patient orange juice.: Administering juice may be appropriate if hypoglycemia is confirmed, but giving it before verifying blood glucose could mask other causes of tremors and nervousness. Assessment first ensures safe and effective intervention.

A. Constipation and dry mouth: Metoprolol does not commonly affect gastrointestinal motility or salivary gland secretion, so these symptoms are not typical adverse effects. Such findings are more often linked to anticholinergic medications.

B. Signs of heart failure such as edema and weight gain: Metoprolol can reduce cardiac contractility, which may worsen heart failure in susceptible patients. Fluid retention, swelling, and rapid weight gain signal declining cardiac output and require prompt evaluation.

C. Signs of hyperactivity: Metoprolol slows conduction through the AV node and decreases sympathetic activity, which usually causes fatigue rather than stimulation. Hyperactivity does not align with its mechanism of action and would be unlikely to occur with therapeutic dosing.

D. Increased energy and appetite: Beta-blockers often cause lethargy or exercise intolerance due to reduced heart rate and cardiac workload. Increased energy or appetite would be inconsistent with these physiologic effects. Assessing for such symptoms would not provide relevant information regarding medication safety.