A nurse is teaching a patent who is taking warfarin for deep venous thrombosis. Which statement by the patient indicates a need for further teaching?

A. Diarrhea: Diarrhea is not a common side effect of metoprolol, a beta-blocker medication commonly used to treat hypertension. While gastrointestinal side effects such as nausea or constipation may occur, diarrhea is not typically associated with metoprolol use.

B. Insomnia: Insomnia, or difficulty falling or staying asleep, is a potential side effect of metoprolol. Beta-blockers like metoprolol may interfere with sleep patterns in some individuals, leading to insomnia. It is important for the nurse to assess the patient for changes in sleep patterns while taking metoprolol.

C. Urinary retention: Urinary retention, or the inability to completely empty the bladder, is not a common side effect of metoprolol. In fact, beta-blockers like metoprolol are more likely to cause urinary frequency or urgency rather than retention.

D. Gum changes: Gum changes, such as gingival hyperplasia, are not typically associated with metoprolol use. This side effect is more commonly associated with certain other medications, such as calcium channel blockers or anticonvulsants.

A. Reluctance to monitor blood pressure at home: One barrier to blood pressure management in patients newly diagnosed with hypertension is reluctance or resistance to monitor blood pressure at home. Home blood pressure monitoring is an essential component of hypertension management as it allows patients and healthcare providers to track blood pressure trends, assess the effectiveness of treatment, and make adjustments as needed. However, some patients may feel apprehensive about self-monitoring or may lack understanding of its importance, leading to reluctance to engage in this aspect of their care. Addressing this barrier requires patient education, encouragement, and support to promote the benefits of home blood pressure monitoring and empower patients to take an active role in managing their hypertension.

B. Reduction in work hours: While work-related stress and long working hours can contribute to hypertension, a reduction in work hours would not typically be considered a barrier to blood pressure management, especially if it allows for better stress management, lifestyle modifications, and adherence to treatment regimens.

C. Initiation of an exercise plan: Starting an exercise plan is generally considered a positive step in blood pressure management rather than a barrier. Regular physical activity helps lower blood pressure, improve cardiovascular health, and promote overall well-being. However, barriers related to exercise adherence, such as lack of time, motivation, or access to suitable facilities, could hinder effective blood pressure management.

D. Preference for a low sodium diet: Opting for a low sodium diet is beneficial for individuals with hypertension as it helps reduce blood pressure levels and lowers the risk of cardiovascular events. Therefore, a preference for a low sodium diet would not be considered a barrier to blood pressure management. However, barriers related to dietary adherence, such as taste preferences, cultural influences, or difficulty in meal planning, may need to be addressed to support long-term dietary changes and improve blood pressure control.