A nurse is collecting data from an older adult client who is receiving ondansetron IV, has a history of diabetes mellitus and cardiac myopathy, and is receiving chemotherapy to treat cancer. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply)

A. Infiltration occurs when IV fluid or medication leaks into the surrounding tissues rather than entering the vein. Coolness, blanching (pale appearance), swelling, and discomfort at the IV site are common signs of infiltration.

B. Local inflammation at the IV site can occur due to irritation or infection. Redness, warmth, swelling, tenderness, and possibly purulent drainage (pus) are typical signs. The description of a cool and blanched IV site does not fit the typical signs of inflammation, which usually involve warmth and redness.

C. Thrombophlebitis is inflammation of a vein with associated blood clot formation. Pain, warmth, redness, and swelling along the path of the vein are common. Thrombophlebitis typically presents with warmth and redness at the site, whereas the cool and blanched appearance described by the student suggests fluid infiltration rather than a thrombus causing inflammation.

D. Phlebitis is inflammation of the vein itself. Pain, redness, warmth, and swelling directly over the vein. Phlebitis usually manifests with warmth and redness, which are not present in the described symptoms.

B. It occurs when there is an abnormally high concentration of potassium in the bloodstream, typically above 5.0 mEq/L. Symptoms of hyperkalemia can include chest pain, palpitations, muscle weakness, and potentially life-threatening cardiac arrhythmias.

A. Hypercalcemia refers to elevated levels of calcium in the blood, not potassium.

C. Hypokalemia is the opposite condition where there is a lower-than-normal level of potassium in the blood.

D Hyponatremia refers to a low sodium level in the blood.