A nurse is assisting with a presentation about caring for clients who are receiving diuretic therapy. The nurse should explain that which of the following medications can put clients at risk for hyperkalemia?

(A) Meloxicam 5 mg PO once daily: Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. It does not typically affect potassium levels.

(B) Acyclovir 400 mg PO twice daily: Acyclovir is an antiviral medication used to treat viral infections such as herpes simplex and varicella-zoster. It does not typically affect potassium levels.

(c) Furosemide 80 mg PO daily: Furosemide is a loop diuretic that promotes diuresis by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle and distal renal tubule. This can lead to increased excretion of potassium in the urine, potentially causing hypokalemia.

(D) Cimetidine 300 mg PO four times per day: Cimetidine is a histamine H2 receptor antagonist used to treat and prevent certain types of ulcer, and to treat conditions that cause the stomach to produce too much acid. It does not typically affect potassium levels.

A. Positive Kernig's sign:

Positive Kernig's sign is associated with meningitis, not thrombosis. It is a clinical sign where pain is elicited when the hip is flexed at a 90-degree angle and then the knee is extended. This sign is not relevant for identifying a thrombus.

B. Dull, aching calf pain:

Dull, aching calf pain is a common symptom of deep vein thrombosis (DVT). Pain, swelling, and tenderness in the calf are typical manifestations of a thrombus in the leg veins. This symptom should alert the nurse to the possibility of a thrombus.

C. Soft, pliable calf muscle:

A soft, pliable calf muscle is not indicative of a thrombus. In the case of DVT, the affected leg is usually swollen, firm, and tender. Thus, this manifestation does not suggest the presence of a thrombus.

D. Positive Homan's sign:

Positive Homan's sign is identified when there is pain in the calf upon dorsiflexion of the foot. This sign can be indicative of DVT. Although not highly specific or sensitive, it is one of the traditional signs used to assess for the presence of a thrombus in the leg.