A client who has heart failure tells the nurse, “I have been taking my furosemide as prescribed, but I still feel short of breath.” Which of the following statements should the nurse make?

You should notify your provider if you experience weight gain. This is because weight gain can indicate fluid retention, which can worsen heart failure and cause more shortness of breath. Furosemide is a diuretic that helps reduce fluid overload, but it may not be enough to control the symptoms of heart failure. Therefore, the provider may need to adjust the dose or add another medication.

Choice A is wrong because you should not increase your intake of foods high in potassium. Furosemide can cause potassium loss, but increasing potassium intake can lead to hyperkalemia, which can affect the heart rhythm and function. You should follow the provider’s advice on how much potassium to consume and have your potassium levels checked regularly.

Choice B is wrong because you should not decrease your intake of fluids. Dehydration can cause low blood pressure, kidney damage, and electrolyte imbalance, which can also affect the heart. You should drink enough fluids to stay hydrated, but not too much to cause fluid overload. The provider may give you a specific amount of fluid to drink per day based on your condition.

Choice D is wrong because you should not take your medication with food. Furosemide is best absorbed on an empty stomach, and food can interfere with its effectiveness. You should take furosemide at least one hour before or two hours after meals.

The correct answer is A, C, E.

Choice A reason:

Hyperkalemia is a known adverse effect of spironolactone because it is a potassium-sparing diuretic. This means it prevents the excretion of potassium, which can lead to elevated levels of potassium in the blood. Normal potassium levels range from 3.5 to 5.0 mEq/L.

Choice B reason:

Hypokalemia is unlikely with spironolactone use because, as a potassium-sparing diuretic, it typically leads to increased potassium levels, not decreased.

Choice C reason:

Gynecomastia, or enlargement of male breast tissue, is an adverse effect of spironolactone. This is likely due to its antiandrogenic effects, which can interfere with hormone levels.

Choice D reason:

Menorrhagia, or heavy menstrual bleeding, is not commonly associated with spironolactone. This medication does not typically affect menstrual volume or frequency.

Choice E reason:

Impotence can occur as an adverse effect of spironolactone due to its potential impact on sex hormones. It may cause erectile dysfunction or other issues related to sexual function.