A nurse is caring for a 78-year-old client who was recently admitted from the emergency room and is reporting weakness.

Exhibits

Select words from the choices below to fill in each blank in the following sentence.

The nurse has reviewed the client's medical record.

The client is at risk for developing metabolic acidosis hypernatremia

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and

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A. Thrombocytopenia (low platelet count) predisposes the client to spontaneous bleeding. This can manifest as petechiae (small red or purple spots on the skin), purpura (larger areas of purple discoloration), mucosal bleeding (such as nosebleeds or bleeding gums), or internal bleeding (such as gastrointestinal or intracranial bleeding). Monitoring for signs of bleeding is essential to promptly intervene and prevent complications.
B. While infections can occur in any client, a low platelet count does not directly predispose the client to infection. Thrombocytopenia primarily affects hemostasis rather than immune function.
C. Oliguria refers to decreased urine output, typically less than 400 mL/day in adults. It is not directly related to thrombocytopenia but may occur in conditions affecting kidney function or fluid balance.
D. Hyperactive deep tendon reflexes can indicate neurological conditions or electrolyte imbalances but are not associated with thrombocytopenia.

A. Furosemide can increase serum uric acid levels, leading to hyperuricemia. This occurs due to the drug's effects on renal excretion of uric acid. Hyperuricemia can predispose the client to gouty arthritis or kidney stones.
B. Furosemide typically leads to sodium loss (natriuresis) rather than hypernatremia. It is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending loop of Henle in the kidneys, promoting diuresis and reducing fluid overload.
C. Furosemide-induced diuresis can cause loss of chloride ions along with sodium, potentially leading to hypochloremia rather than hyperchloremia. Hyperchloremia is less common unless there are other contributing factors such as concurrent administration of saline solutions or underlying conditions.
D. Furosemide does not typically cause hypercalcemia. In fact, it can lead to mild hypocalcemia due to increased urinary calcium excretion. Loop diuretics like furosemide impair calcium reabsorption in the kidneys, which can lead to calcium wasting.