A nurse is caring for a client who has hypertension and is prescribed metoprolol, a beta blocker. The nurse should monitor the client for which of the following adverse effects?
A.
Tachycardia
B.
Hyperglycemia
C.
Bronchospasm
D.
Hyperkalemia.
The correct answer and Explanation is :
The correct answer is C. Bronchospasm.
Explanation:
Metoprolol is a selective beta-1 adrenergic blocker primarily used to manage hypertension and certain cardiac conditions. While it primarily targets the heart, there are important considerations regarding its effects on the respiratory system, particularly in patients with a history of asthma or chronic obstructive pulmonary disease (COPD).
Adverse Effects of Metoprolol:
- Bronchospasm (C): Metoprolol can lead to bronchospasm, especially in individuals with pre-existing respiratory conditions. While it is a selective beta-1 blocker, at higher doses or in sensitive individuals, it can still block beta-2 receptors, which are responsible for bronchodilation. This can result in constriction of the airways, leading to difficulty in breathing, wheezing, and exacerbation of asthma symptoms.
- Tachycardia (A): Metoprolol is actually used to treat tachycardia, as it works to lower heart rate and blood pressure. Monitoring for tachycardia is less of a concern with metoprolol unless the patient has been improperly dosed or has other factors contributing to increased heart rate.
- Hyperglycemia (B): While beta blockers can mask the symptoms of hypoglycemia in diabetic patients, they are not typically associated with causing hyperglycemia. In fact, some beta blockers may help improve insulin sensitivity over time.
- Hyperkalemia (D): Hyperkalemia is not a common side effect of metoprolol. Although beta blockers can influence potassium levels, metoprolol is more likely to have neutral effects on serum potassium compared to some other antihypertensives, such as ACE inhibitors or potassium-sparing diuretics.
Conclusion:
In clinical practice, nurses must be vigilant about monitoring patients for signs of bronchospasm, particularly in those with a history of respiratory issues, and ensure that they educate patients about potential respiratory side effects associated with beta blockers like metoprolol.