A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Hypokalemia. Hydrochlorothiazide is a diuretic that works by increasing the excretion of water and electrolytes, including potassium. Hypokalemia is a common adverse effect of hydrochlorothjsoniazide due to excessive potassium loss through diuresis. Potassium plays a crucial role in maintaining proper cardiac function, so monitoring for hypokalemia is essential to prevent cardiac complications like arrhythmias. Option B) Hypertension is incorrect because hydrochlorothiazide is actually prescribed to treat hypertension by reducing blood volume and lowering blood pressure. Option C) Hyperglycemia is incorrect because hydrochlorothiazide does not typically have a direct effect on blood glucose levels. Option D) Hypercalcemia is incorrect because hydrochlorothiazide can actually lead to decreased calcium levels due to increased renal excretion. In an educational context, understanding the adverse effects of medications is crucial for nurses to provide safe and effective care to their patients. Monitoring for potential adverse effects allows nurses to intervene promptly and prevent complications. This knowledge also helps nurses educate patients about medication side effects and the importance of compliance with monitoring protocols.

Correct Answer: B

Rationale: When a client is prescribed furosemide, it is important to monitor for fluid loss. Weighing oneself daily helps track changes in weight due to fluid loss, which can indicate the effectiveness of the medication. This monitoring assists in managing fluid balance and adjusting the dosage if necessary to achieve the desired therapeutic effect.

Correct Answer: A

Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia as an adverse effect. Hyperkalemia is characterized by elevated levels of potassium in the blood, which can be dangerous and lead to cardiac arrhythmias. Therefore, monitoring for signs and symptoms of hyperkalemia is crucial when a client is taking spironolactone.

Correct Answer: B

Rationale: In pharmacology, monitoring laboratory values is crucial to ensure the effectiveness and safety of medications. When a client is receiving vancomycin, monitoring creatinine levels is essential to evaluate the therapeutic effect of the medication. Creatinine levels reflect kidney function, and vancomycin is primarily excreted through the kidneys. Elevated creatinine levels may indicate potential kidney damage or impaired drug clearance, necessitating dose adjustments to prevent toxicity. The other options, BUN, hemoglobin, and white blood cell count, are not directly related to monitoring the therapeutic effect of vancomycin. Blood urea nitrogen (BUN) primarily reflects kidney function but is not as specific as creatinine for monitoring vancomycin therapy. Hemoglobin levels are more relevant for assessing anemia or oxygen-carrying capacity of the blood, while white blood cell count is indicative of the body's immune response and not specific to vancomycin therapy. Educationally, understanding the rationale behind monitoring specific laboratory values for different medications enhances a nurse's ability to provide safe and effective care to clients. It reinforces the importance of pharmacological knowledge in clinical practice and promotes critical thinking skills to make informed decisions regarding medication management based on individual client needs.

Correct Answer: D

Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment.