Prior to writing a prescription for metoprolol, the provider would evaluate the client's history for which diagnoses that would be dangerous? Select all that apply.

Rationale: A. Hyperlipidemia: Elevated lipid levels do not directly increase the risk of adverse effects from metoprolol. While long-term beta-blocker use may slightly affect lipid metabolism, hyperlipidemia is not a contraindication or immediate danger for prescribing metoprolol. B. Hypotension: Metoprolol lowers blood pressure by reducing cardiac output and inhibiting sympathetic stimulation. In clients with preexisting hypotension, metoprolol can exacerbate low blood pressure, leading to dizziness, syncope, or shock, making this a critical contraindication to assess. C. Heart block: Metoprolol slows atrioventricular conduction through beta-1 receptor blockade. In clients with existing second- or third-degree heart block, this can precipitate severe bradyarrhythmias, complete heart block, or cardiac arrest, requiring careful evaluation before administration. D. Hyperglycemia: While beta-blockers can mask hypoglycemia symptoms, hyperglycemia itself does not pose an immediate danger when using metoprolol. Monitoring may be needed for diabetic clients, but it is not a primary contraindication. E. Bradycardia: Metoprolol decreases heart rate by reducing sympathetic stimulation. Preexisting bradycardia increases the risk of severe heart rate suppression, syncope, or cardiac arrest, making it a significant concern prior to prescribing.