A client is prescribed a noncardioselective beta blocker. What nursing intervention is a priority?

• A. Assessment of blood glucose levels
• B. Respiratory assessment
• C. Orthostatic blood pressure assessment
• D. Teaching about potential tachycardia

Answer: (B)

Noncardioselective beta blockers block beta-1 and beta-2 receptors, and blocking beta-2 in the lungs can cause bronchoconstriction. Because airway reactivity is a potential and immediate safety concern with these medications, the priority nursing assessment is the patient’s respiratory status. The nurse should quickly assess for signs of airway compromise—note respiratory rate and effort, listen for wheezes, check oxygen saturation, and monitor for shortness of breath or chest tightness. If any airway symptoms occur, the medication should be held and the prescriber notified promptly.

Context: noncardioselective agents like propranolol can worsen asthma or COPD due to bronchospasm, which is why respiratory monitoring takes precedence. Other considerations, such as blood glucose monitoring or blood pressure/orthostatic changes, are important but not as immediately critical as preventing and detecting breathing difficulties in this scenario.