What sign should the nurse monitor for in a client receiving bethanechol chloride to prevent cholinergic overdose?

When monitoring a client receiving bethanechol chloride, it is crucial to keep an eye on bradycardia as a sign of potential cholinergic overdose. Bethanechol is a cholinergic agonist that stimulates the parasympathetic nervous system, leading to increased acetylcholine activity and resulting in various physiological effects. One of the predominant effects is a decrease in heart rate due to increased vagal tone, which could lead to bradycardia.

Cholinergic overdose can manifest with symptoms such as excessive salivation, lacrimation, urination, diarrhea, gastrointestinal distress, and bradycardia. Monitoring heart rate is vital, as bradycardia can lead to hypotension and other cardiovascular complications. Thus, recognizing and promptly addressing bradycardia as a sign of excessive cholinergic stimulation is important for patient safety and effective management of treatment.

In this context, tachycardia and hypertension are not associated with cholinergic effects, and dry mouth would typically indicate insufficient cholinergic activity rather than an overdose. Therefore, bradycardia serves as a critical indicator that necessitates careful monitoring and possible intervention in a patient receiving bethanechol chloride.