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) Decreased stimulation of the sympathetic nervous system (SNS): The sympathetic nervous system (SNS) plays a key role in regulating blood pressure. When the SNS is stimulated, it causes vasoconstriction, or narrowing of the blood vessels, which increases blood pressure. Therefore, decreased stimulation of the SNS would typically lead to vasodilation, or widening of the blood vessels, which would lower blood pressure, not increase it.

(B) Decreased elasticity of blood vessels: As people age, their blood vessels can lose elasticity, which can lead to hypertension. When blood vessels are elastic, they can easily expand and contract with each heartbeat, maintaining a healthy blood pressure. But when they become stiff or rigid, they can’t expand as easily, causing the pressure inside to increase.

(c) Increased peripheral vascular resistance (PVR): Peripheral vascular resistance is the resistance that blood must overcome to flow through the blood vessels. The more resistance, the harder the heart has to work to pump blood through the body, which can lead to increased blood pressure. Factors that can increase PVR include vasoconstriction, or narrowing of the blood vessels, and increased blood viscosity, or thickness.

(D) Decreased fluid volume: Decreased fluid volume, or hypovolemia, would typically lead to a decrease in blood pressure, not an increase. This is because blood pressure is directly related to the volume of blood in the blood vessels. When there’s less blood, the pressure inside the blood vessels is usually lower.

(E) Increased blood viscosity: Blood viscosity refers to the thickness of the blood. When blood is thicker, it’s harder for it to flow through the blood vessels, which increases the resistance to blood flow, leading to increased blood pressure.

A. Arrange referral for family therapy to deal with home stressors:

While family therapy may be beneficial in addressing underlying issues, suspected abuse must be reported promptly to protect the client's safety. Referral for family therapy can be considered as part of a comprehensive intervention plan but should not delay reporting of suspected abuse.

B. Follow the agency's guidelines for reporting suspected abuse:

Reporting suspected abuse is the first priority when there are concerns about a client's safety. Following the agency's guidelines ensures that the appropriate authorities are notified and that the client receives the necessary protection and support.

C. Check the bruises at the next visit to the client's home:

Delaying action and waiting until the next visit to check the bruises could put the client at further risk of harm. Suspected abuse requires immediate attention, and the nurse should follow established protocols for reporting and intervening in such situations.

D. Institute more frequent visits to the client's home:

While more frequent visits may allow for closer monitoring of the client's condition, suspected abuse should be addressed immediately through appropriate reporting channels. Increasing visit frequency alone may not adequately address the safety concerns and may delay necessary intervention.