A nurse is caring for a client in a provider's office.

Exhibits
Click to highlight the findings that indicate an adverse effect of the medication. To deselect a finding, click on the finding again.

Nurses' Notes

Today:

Client returns for follow-up visit after starting labetalol. Client reports feeling more tired since starting the medication and is having trouble sleeping. Client states. "I have also had loose stools several times this week and often get dizzy whenever I stand up."

Vital Signs

Today:

Temperature 37° C (98.6°F)

Heart rate 56/min

Respiratory rate 14/min

Blood pressure 118/76 mm Hg

feeling more tired

loose stools several times this week

dizzy whenever I stand up

Client returns for follow-up visit after starting labetalol

Heart rate 56/min

Answer and Explanation

The Correct Answer is ["A","B","C","E"]

●   Heart rate 56/min (bradycardia): Labetalol, a beta blocker, can lower the heart rate, leading to bradycardia, which may cause symptoms such as fatigue, dizziness, or weakness.
●   Dizziness when standing up (orthostatic hypotension): Labetalol can cause a drop in blood pressure when standing, resulting in dizziness or lightheadedness due to orthostatic hypotension.
●   Loose stools several times this week (gastrointestinal effects): Diarrhea or other gastrointestinal disturbances are possible side effects of labetalol. These can occur as the body adjusts to the medication.
●   Feeling more tired (fatigue): Fatigue is a common adverse effect of beta blockers like labetalol, often due to the medication’s heart rate-lowering and blood pressure-lowering effects.
●   Temperature 37° C (98.6°F): Normal temperature, indicating no signs of infection.
●   Blood pressure 118/76 mm Hg: This shows a good response to the medication, with controlled blood pressure, a positive effect of labetalol.

Nursing Test Bank

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Correct Answer is C

Explanation

A. Bradycardia: While bradycardia is a known side effect of digoxin and warrants monitoring, it is expected in some patients and may not always require immediate provider notification unless it becomes severe or symptomatic.

B. Blurred vision: Blurred or yellow vision is a classic sign of digoxin toxicity. However, it typically develops gradually, and while concerning, it is not as urgent as hypokalemia, which can rapidly worsen digoxin toxicity and lead to life-threatening arrhythmias.

C. Hypokalemia: Hypokalemia significantly increases the risk of digoxin toxicity, including dangerous cardiac arrhythmias. It must be corrected promptly, and digoxin administration should be held until potassium levels are addressed. This finding requires immediate provider notification.

D. Anorexia: Anorexia is an early symptom of digoxin toxicity, but it does not carry the same immediate risk as hypokalemia. It should be reported, but it does not demand as urgent an intervention as correcting low potassium levels.

A. Blood pressure 122/88 mm Hg B. Pupils equal, round, react to light, accommodation C. 1+ deep tendon reflexes D. 24 hr urine output 960 mL

Correct Answer is C

Explanation

A. Blood pressure 122/88 mm Hg: This blood pressure is within a normal range, especially for a client receiving magnesium sulfate to manage preeclampsia. Magnesium sulfate works to control blood pressure in preeclampsia, so this is not a concerning finding.

B. Pupils equal, round, react to light, accommodation: This is a normal neurological finding. Magnesium sulfate does not typically cause changes in pupil response unless toxicity occurs. Since the pupils are reacting normally, no immediate concern is indicated.

C. 1+ deep tendon reflexes: Deep tendon reflexes of 1+ are a sign of mild depression of reflexes, which can be an early sign of magnesium sulfate toxicity. Magnesium sulfate toxicity commonly presents with absent reflexes (0), and 1+ reflexes suggest the client may be nearing toxicity. This requires monitoring and should be reported to the provider.

D. 24 hr urine output 960 mL: A urine output of 960 mL over 24 hours is within the expected range (greater than 720 mL/24 hours or 30 mL/hr). This indicates adequate renal function and does not suggest a need for intervention or reporting.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client prior to administering digoxin. Which of the following findings should the nurse immediately report to the provider?

Correct Answer is C

Explanation

A nurse is assessing a client who is receiving IV magnesium sulfate for treatment of preeclampsia. Which of the following findings should the nurse report?

Correct Answer is C

Explanation

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