Final answer:
A nurse should monitor for apprehension, hypotension, auditory changes, and bradycardia when a client receives lidocaine IV, as these effects are linked to its action on voltage-gated sodium channels, leading to anesthesia and potential cardiovascular or central nervous system effects.
Step-by-step explanation:
The nurse should monitor a client receiving lidocaine (Xylocaine) IV closely for the following: apprehension, hypotension, auditory changes, and bradycardia. These side effects can be attributed to lidocaine's action on blocking voltage-gated sodium channels, which is also how the drug provides local anesthesia.
Lidocaine's mechanism of action involves blocking the conduction of nerve impulses by inhibiting the influx of sodium ions through voltage-gated sodium channels in neuronal membranes. This leads to a failure of action potential generation and propagation, resulting in the absence of pain perception. In addition, systemic effects of lidocaine due to higher concentrations can affect the cardiovascular system, leading to possible hypotension and bradycardia. Lidocaine can also affect the central nervous system, potentially causing apprehension or auditory changes.
Heartburn is not a commonly recognized side effect of IV lidocaine and is therefore not a focus of monitoring for this medication.