Which of the following is a potential adverse reaction to betamethasone?

Choice A rationale Betamethasone is a potent synthetic glucocorticoid corticosteroid. Its mechanism involves complex metabolic effects, including promoting gluconeogenesis (glucose production) and reducing peripheral glucose uptake and utilization by decreasing insulin sensitivity. This action can lead to hyperglycemia (elevated blood glucose, normal fasting range is 70-100 mg/dL), requiring careful monitoring, especially in pregnant clients with gestational diabetes. Choice B rationale Corticosteroids like betamethasone can cause hypokalemia (low potassium, normal range 3.5-5.0 mEq/L) due to their mineralocorticoid-like effect, which promotes sodium reabsorption in exchange for potassium excretion in the renal tubules. Therefore, it is more likely to cause hypokalemia than hyperkalemia (elevated potassium), making this option an incorrect adverse reaction. Choice C rationale Betamethasone is not typically associated with hypotension (low blood pressure). If anything, the mineralocorticoid effects of corticosteroids can sometimes lead to fluid retention and an increase in blood pressure due to increased sodium reabsorption, although this is less pronounced than with true mineralocorticoids, and the primary concern is the metabolic effect. Choice D rationale Bradycardia (slow heart rate, normal newborn heart rate 110-160 beats per minute) is not a characteristic adverse reaction of systemic corticosteroids like betamethasone. While some drugs affect heart rate, glucocorticoids generally have a minimal direct impact on cardiac chronotropy at therapeutic doses, and their main adverse effects are metabolic and immune-related.