What adverse effect should a nurse instruct a client taking nifedipine for gestational hypertension to report?

When a client is prescribed nifedipine for gestational hypertension, it is important to monitor for specific adverse effects due to the drug's mechanism of action as a calcium channel blocker. One significant adverse effect to be aware of is an irregular heartbeat, which can indicate potentially serious cardiovascular complications.

Nifedipine works by relaxing the smooth muscle in blood vessels, leading to vasodilation and a reduction in blood pressure. However, this vasodilation can sometimes result in reflex tachycardia or other arrhythmias as the body attempts to compensate for the lowered blood pressure. Irregular heartbeat may manifest as palpitations or a rapid heartbeat, which could signal that the heart is struggling to maintain an adequate rhythm under the influence of the medication. Therefore, instructing the client to report any irregularities in their heartbeat is crucial for ensuring prompt medical intervention and preventing further complications.

The other options listed, while they may occur with nifedipine use, are generally less critical to report immediately. Headaches, for example, are common and can often signal the initial response to blood pressure changes. Swelling in extremities can occur due to peripheral edema, a known side effect of calcium channel blockers but is not considered as immediately dangerous as