The client with pernicious anemia asks why vitamin B12 injections are necessary. What is the best response by the nurse?

Choice A reason: Placing the call bell in reach of the client is the most appropriate nursing action following the administration of metoprolol, a beta-blocker that lowers blood pressure and heart rate. ¹ The client may experience dizziness, lightheadedness, or fainting as side effects of the medication, especially after the first dose. ² The call bell allows the client to alert the nurse if they need assistance or experience any adverse reactions.

Choice B reason: Taking a pulse oximetry reading is not the most appropriate nursing action following the administration of metoprolol. Pulse oximetry measures the oxygen saturation of the blood, which is not directly affected by metoprolol. ³ A more relevant vital sign to monitor is the blood pressure and heart rate, which can indicate the effectiveness and safety of the medication.

Choice C reason: Recording the client's weight is not the most appropriate nursing action following the administration of metoprolol. Weight is not a sensitive indicator of the immediate effects of metoprolol. Weight may be monitored periodically to assess the client's fluid status and possible signs of heart failure, which metoprolol can help prevent. ¹ However, this is not a priority action after the first dose of the medication.

Choice D reason: Encouraging oral fluids is not the most appropriate nursing action following the administration of metoprolol. Oral fluids may help prevent dehydration and constipation, which can occur as side effects of metoprolol. ² However, excessive fluid intake may worsen the client's blood pressure and heart function, which metoprolol aims to improve. The nurse should advise the client to drink fluids as directed by the provider and report any signs of fluid overload, such as swelling, shortness of breath, or weight gain.

Choice A reason: This is not a correct answer. A decrease in urination is not a common side effect of amlodipine. Amlodipine is a calcium channel blocker that lowers the blood pressure and relaxes the blood vessels. Amlodipine does not affect the kidney function or the urine output, unless there is an underlying renal problem or a drug interaction. The client should monitor their urination, but not expect a decrease.

Choice B reason: This is the correct answer. An increase in lower extremity edema is a common side effect of amlodipine. Amlodipine can cause fluid retention and swelling in the legs, ankles, or feet. This is due to the dilation of the blood vessels and the leakage of fluid into the tissues. The client should monitor their weight and the size of their lower extremities, and report any significant changes to their health care provider. The client may also elevate their legs, wear compression stockings, or take diuretics to reduce the edema.

Choice C reason: This is not a correct answer. Tachycardia during exercise is not a common side effect of amlodipine. Amlodipine can lower the heart rate and the cardiac output, which can reduce the oxygen demand of the heart. Amlodipine does not cause an increase in the heart rate, unless there is an underlying cardiac problem or a drug interaction. The client should monitor their pulse and blood pressure, but not expect tachycardia.

Choice D reason: This is not a correct answer. An increase in bowel motility is not a common side effect of amlodipine. Amlodipine does not affect the gastrointestinal system or the digestion, unless there is an allergic reaction or a drug interaction. Amlodipine can cause some gastrointestinal side effects, such as nausea, abdominal pain, or constipation, but not an increase in bowel motility. The client should monitor their bowel movements, but not expect an increase.

Choice A reason: This is not a correct answer. A decrease in urination is not a common side effect of amlodipine. Amlodipine is a calcium channel blocker that lowers the blood pressure and relaxes the blood vessels. Amlodipine does not affect the kidney function or the urine output, unless there is an underlying renal problem or a drug interaction. The client should monitor their urination, but not expect a decrease.

Choice B reason: This is the correct answer. An increase in lower extremity edema is a common side effect of amlodipine. Amlodipine can cause fluid retention and swelling in the legs, ankles, or feet. This is due to the dilation of the blood vessels and the leakage of fluid into the tissues. The client should monitor their weight and the size of their lower extremities, and report any significant changes to their health care provider. The client may also elevate their legs, wear compression stockings, or take diuretics to reduce the edema.

Choice C reason: This is not a correct answer. Tachycardia during exercise is not a common side effect of amlodipine. Amlodipine can lower the heart rate and the cardiac output, which can reduce the oxygen demand of the heart. Amlodipine does not cause an increase in the heart rate, unless there is an underlying cardiac problem or a drug interaction. The client should monitor their pulse and blood pressure, but not expect tachycardia.

Choice D reason: This is not a correct answer. An increase in bowel motility is not a common side effect of amlodipine. Amlodipine does not affect the gastrointestinal system or the digestion, unless there is an allergic reaction or a drug interaction. Amlodipine can cause some gastrointestinal side effects, such as nausea, abdominal pain, or constipation, but not an increase in bowel motility. The client should monitor their bowel movements, but not expect an increase.