Question

The client has diabetes mellitus type I. The physician has prescribed metoprolol (Lopressor) for this client. Which symptoms would the nurse recognize as most significant to report to the physician?

1. Dizziness upon standing, and insomnia
2. Palpitations, diaphoresis, and anxiety
3. Blurred vision, fatigue, and dry mouth
4. Pulse of 60, anxiety, and bleeding gums

Answer 1

The nurse would recognize symptoms 2, "Palpitations, diaphoresis, and anxiety," as most significant to report to the physician.

Step-by-step explanation:

Metoprolol, a beta-blocker, is commonly prescribed for conditions like hypertension and angina. In diabetes mellitus type I, managing cardiovascular health is crucial. Symptoms such as palpitations, diaphoresis, and anxiety are indicative of potential adverse effects of metoprolol in this context.

Palpitations may suggest bradycardia, a side effect of beta-blockers like metoprolol, which can be problematic in a patient with diabetes. Diaphoresis (excessive sweating) and anxiety may indicate sympathetic nervous system suppression, potentially worsening hypoglycemic awareness in diabetic patients. These symptoms collectively warrant prompt medical attention to assess the medication's impact on the patient's cardiovascular and glycemic status.

It's essential for the nurse to recognize that metoprolol can mask signs of hypoglycemia, making it challenging for the client to detect low blood sugar levels. This underscores the importance of reporting symptoms related to autonomic nervous system function, such as palpitations, diaphoresis, and anxiety, to the physician.

A collaborative approach involving the healthcare team is crucial in optimizing the patient's treatment plan while managing the complexities of coexisting conditions like diabetes mellitus type I.