A patient with chemotherapy-induced nausea has been prescribed metoclopramide. What adverse effect should the nurse report?

Choice A rationale

Hypertension, or high blood pressure, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s blood pressure during any infusion, hypertension alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice B rationale

A scratchy throat could be a sign of an allergic reaction to piperacillin-tazobactam. Allergic reactions to medications can range from mild to severe, and can include symptoms such as hives, difficulty breathing, and swelling in the face or throat. If a client reports a scratchy throat shortly after starting an infusion of piperacillin-tazobactam, it would be prudent for the nurse to stop the infusion and assess the client for other signs of an allergic reaction.

Choice C rationale

Bradycardia, or a slow heart rate, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s heart rate during any infusion, bradycardia alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice D rationale

Pupillary constriction is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s pupils during any infusion, pupillary constriction alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice A rationale

Labetalol is a non-selective beta-blocker used to treat hypertension. The goal of labetalol administration is to reduce the blood pressure to 140/90 mmHg, and the diastolic BP must not fall below 90 mmHg. However, in this scenario, the client’s heart rate is 48 beats/minute, which is lower than the normal range (60-100 beats/minute). Administering labetalol, which can further decrease heart rate, could lead to bradycardia, a condition that can cause fainting, fatigue, or chest discomfort. Therefore, the nurse should withhold the scheduled dose and notify the healthcare provider.

Choice B rationale

While it is important to monitor the client’s BP regularly when administering labetalol, given the client’s low heart rate, administering the dose could potentially exacerbate the client’s bradycardia. Therefore, this choice is not the most appropriate action for the nurse to take in this situation.

Choice C rationale

Assessing for orthostatic hypotension before administering the dose is an important consideration when administering medications that can lower blood pressure. However, in this case, the client’s low heart rate is a more immediate concern. Therefore, this choice is not the most appropriate action for the nurse to take in this situation.

Choice D rationale

Applying a telemetry monitor could help in monitoring the client’s heart rate and rhythm. However, given the client’s current heart rate, the priority should be to withhold the medication and inform the healthcare provider.