The nurse is evaluating the effects of the prescribed carvedilol 6.25 mg PO daily for a client with a history of unstable angina. Which of the following reflects that the medication has been effective?

Choice A reason: Tinnitus is not a common or serious side effect of digoxin, a drug that strengthens the contraction of the heart and regulates the heart rhythm. ¹ Tinnitus is a ringing or buzzing sound in the ears that can be caused by many factors, such as ear infections, loud noises, or medications. ² However, digoxin is not known to cause tinnitus, and it is not a reason to call the healthcare provider.

Choice B reason: Constipation is not a common or serious side effect of digoxin. Digoxin does not affect the bowel function, and it is not a reason to call the healthcare provider. Constipation can be caused by many factors, such as dehydration, lack of fiber, or medications. ³ The client should drink plenty of fluids, eat high-fiber foods, and exercise regularly to prevent or relieve constipation.

Choice C reason: Visual disturbances are a common and serious side effect of digoxin, and they are a reason to call the healthcare provider. Digoxin can cause changes in vision, such as blurred vision, yellow or green halos around objects, or seeing spots or flashes. ¹ These are signs of digoxin toxicity, which is a potentially life-threatening condition that occurs when the level of digoxin in the blood is too high. The client should report any visual disturbances to the healthcare provider as soon as possible.

Choice D reason: Vertigo is not a common or serious side effect of digoxin. Vertigo is a sensation of spinning or losing balance that can be caused by many factors, such as inner ear problems, head injuries, or medications. However, digoxin is not known to cause vertigo, and it is not a reason to call the healthcare provider.

Choice A reason: Exertional dyspnea is a common symptom of unstable angina, which is caused by reduced blood flow to the heart muscle. Carvedilol is a beta-blocker that reduces the workload of the heart and improves its oxygen supply. Therefore, resolving exertional dyspnea indicates that the medication has been effective.

Choice B reason: A heart rate of 50 beats/minute is not a desired outcome of carvedilol therapy. It may indicate that the dose is too high or that the client has a conduction problem. A normal resting heart rate for adults is between 60 and 100 beats/minute.

Choice C reason: A regular heart rhythm is not a specific indicator of carvedilol effectiveness. Carvedilol can prevent or treat some arrhythmias, but it is not the primary goal of therapy for unstable angina. A regular heart rhythm may also be influenced by other factors such as electrolytes, hydration, and stress.

Choice D reason: A blood pressure of 120/90 is not a sign of carvedilol effectiveness. Carvedilol can lower blood pressure, but it is not the main purpose of treatment for unstable angina. A blood pressure of 120/90 is considered prehypertension, which may increase the risk of cardiovascular complications.