A patient with substance use disorder is being started on methadone. Which of the following is essential for the nurse to monitor? Select all that apply.

Choice A rationale Methadone is metabolized by the liver, and long-term use can lead to liver toxicity and elevated liver enzymes. It is crucial to monitor liver function tests (LFTs) such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to detect hepatic impairment. The normal range for ALT is typically 7 to 56 U/L, and for AST, it is 10 to 40 U/L. Choice B rationale Methadone can affect the cardiovascular system, leading to dose-dependent hypotension or hypertension. Regular blood pressure monitoring is essential to detect and manage these fluctuations, preventing complications like syncope or organ damage. The normal range for blood pressure is less than 120/80 mm Hg, and variations outside this range require careful clinical assessment. Choice C rationale A primary risk of methadone, an opioid, is respiratory depression, which can be life-threatening. This side effect is a major concern, especially when initiating treatment or adjusting the dose. Monitoring the patient's respiratory rate and oxygen saturation is essential for patient safety. A normal respiratory rate for an adult is 12 to 20 breaths per minute. Choice D rationale This choice is incorrect because monitoring liver function, blood pressure, and respiratory status are all essential aspects of care for a patient on methadone due to the drug's systemic effects and potential for adverse reactions. Therefore, none of the above is not a correct answer.