Final answer:
The nurse should immediately notify the provider if extrapyramidal symptoms are observed after administering metoclopramide, as these indicate serious side effects.
Step-by-step explanation:
If a nurse assesses a client who received a preoperative IV dose of metoclopramide 1 hr ago, they should notify the provider if they observe Extrapyramidal symptoms. These symptoms can include movement disorders that are similar to those seen in movement disorders of the extrapyramidal system and are indicative of potentially serious side effects of medication affecting the basal nuclei and dopamine activity. While changes in blood pressure and temperature, as well as respiratory rate fluctuations, can be relevant depending on the severity and context, extrapyramidal symptoms are particularly concerning with metoclopramide and warrant immediate medical attention.