A nurse is reinforcing teaching about the side effects of metoprolol. Which of the following client statements indicates an understanding of the teaching?

Choice A reason: Constipation isn’t a primary effect of disulfiram-alcohol reaction, which causes acetaldehyde buildup, triggering vasodilation and nausea, not gut motility issues. Scientifically, this reaction targets cardiovascular and systemic responses, lacking evidence for significant gastrointestinal stasis as a monitored outcome in this scenario.

Choice B reason: Dry skin isn’t linked to disulfiram-alcohol interaction, which induces flushing and sweating from acetaldehyde toxicity, not dehydration. Scientifically, the reaction affects vascular and autonomic systems, producing moist, not dry, skin responses, making this an unrelated finding for monitoring here.

Choice C reason: Hypotension occurs in disulfiram-alcohol reaction as acetaldehyde dilates vessels, dropping blood pressure. This cardiovascular effect, alongside tachycardia, is a key sign to monitor, aligning with scientific understanding of the drug’s inhibition of aldehyde dehydrogenase, causing systemic distress.

Choice D reason: Urinary retention isn’t a typical disulfiram-alcohol effect; the reaction focuses on vasodilation, nausea, and hypotension from acetaldehyde. Scientifically, autonomic overstimulation may occur, but bladder dysfunction isn’t a primary outcome, making this less critical to monitor than cardiovascular collapse.

Choice A reason: Cardiac medications don’t contraindicate varicella vaccine, a live virus. Unless immunocompromised (e.g., via steroids), cardiac conditions don’t impair immunity enough for risk. Scientifically, this lacks evidence as a barrier, as the vaccine’s safety profile supports use in stable cardiac cases without immune suppression.

Choice B reason: Chemotherapy suppresses immunity, making live vaccines like varicella dangerous due to risk of unchecked viral replication. This contraindication is scientifically grounded, as immunocompromised states (e.g., from cancer treatment) heighten infection risk, necessitating delay until immune recovery per vaccination guidelines.

Choice C reason: Two diarrhea stools in a day isn’t a contraindication unless severe or linked to immunosuppression. Mild illness doesn’t preclude live vaccines; varicella can be given unless fever or systemic compromise exists. Scientifically, this is insufficient to halt immunization based on current evidence.

Choice D reason: Clear rhinorrhea from a cold isn’t a contraindication for varicella vaccine. Mild respiratory symptoms without fever don’t impair immune response significantly. Scientifically, guidelines allow vaccination during minor illnesses, as it poses no increased risk, distinguishing it from severe immune deficits.