A nurse in a provider’s office is caring for a 68-year-old male client who reports changes in activity tolerance, feeling tired all the time, and difficulty remembering things. The client also states they bruise easily.

Exhibits

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, what actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

The nurse should clarify the prescription for Furosemide due to the client’s 2. Potassium level. The client’s potassium level is 3.2 mEq/L, which is below the normal range of 3.5 to 5 mEq/L. This could indicate hypokalemia, a condition that can cause weakness, fatigue, and heart rhythm problems. Therefore, it would be important for the nurse to clarify the prescription for potassium chloride, which is a medication used to treat or prevent low potassium levels. Please note that this is an assessment based on the information provided

Furosemide, also known as a loop diuretic, works by inhibiting the Na+/K+/2Cl- cotransporter in the ascending thick loop of Henle in the kidneys1. This part of the kidney is responsible for reabsorbing sodium, chloride, and potassium from the urine back into the body1.

When Furosemide inhibits this process, it leads to an increase in the amount of these electrolytes in the urine, which in turn leads to their decreased levels in the body1. This is why Furosemide can cause a decrease in potassium levels in the body, a condition known as hypokalemia23.

It’s important to note that while Furosemide helps in relieving the body of excess fluid, its use may lead to the depletion of certain electrolytes in the body, such as potassium3. Therefore, if you are taking Furosemide, your doctor may need to monitor your potassium levels or have you consume more potassium4.

Choice A rationale

Fever is not typically a sign of fluid overload. It’s more commonly associated with a transfusion reaction, which could indicate an immune response to the transfused blood.

Choice B rationale

Dyspnea, or difficulty breathing, can be a sign of fluid overload. When the body has too much fluid, it can put pressure on the lungs, making it harder to breathe.

Choice C rationale

Pruritus, or itching, is not typically a sign of fluid overload. It may be a sign of an allergic reaction to the transfusion.

Choice D rationale

Bradycardia, or a slow heart rate, is not typically a sign of fluid overload. In fact, tachycardia, or a fast heart rate, is more common as the heart works harder to pump the excess fluid.