A nurse is preparing to administer hydrochlorothiazide to a client. Which of the following adverse effects should the nurse monitor the client for?

A) Have the client take the medication on an empty stomach to avoid interactions:
This action may not be appropriate as taking medications on an empty stomach can sometimes increase the risk of adverse effects or decrease medication effectiveness. The decision to take medication with or without food depends on the specific medication and its instructions. It does not address the broader scope of potential interactions with other medications or foods.

B) Consult a drug reference guide for possible interactions:
This is the most appropriate action. Drug reference guides, such as the Physicians' Desk Reference (PDR) or online databases, provide comprehensive information about medications, including potential interactions with other drugs and foods. Consulting a reliable drug reference guide allows the nurse to make informed decisions about medication administration and identify any potential interactions that may affect the client's safety and treatment outcomes.

C) Ask another nurse if they are aware of potential interactions:
While seeking advice from colleagues can sometimes be helpful, relying solely on another nurse's knowledge may not provide comprehensive information about potential interactions. Additionally, the accuracy and reliability of the information obtained from another nurse may vary. Consulting a drug reference guide or other reliable resources is a more systematic approach to ensuring medication safety.

D) Check the client's medical record for medication and food interactions:
While the client's medical record may contain valuable information about their current medications and medical history, it may not always include detailed information about potential interactions with specific foods. Additionally, relying solely on the medical record may overlook recent changes in the client's medication regimen or newly prescribed medications. Consulting a drug reference guide provides more comprehensive and up-to-date information about potential interactions.

A. Decreased jaundice: While spironolactone may indirectly improve liver function in clients with cirrhosis, its primary mechanism of action is to reduce fluid retention by inhibiting aldosterone, thereby decreasing sodium and water retention. Improvement in jaundice may occur over time as liver function improves, but it is not a direct indicator of spironolactone's effectiveness.

B. Decreased ascites: Spironolactone is commonly used to treat ascites, a common complication of cirrhosis resulting from fluid accumulation in the abdomen due to portal hypertension and hypoalbuminemia. The reduction of ascites indicates that spironolactone is effectively reducing fluid retention, a key therapeutic goal in clients with cirrhosis.

C. Increased energy: While improving fluid balance may indirectly contribute to increased energy levels by reducing the symptoms of fluid overload, increased energy is not a direct effect of spironolactone therapy. Other factors, such as improved liver function or nutritional status, may contribute to increased energy levels.

D. Increased appetite: Spironolactone is not typically associated with increasing appetite. While improving fluid balance may indirectly impact appetite by reducing symptoms of fluid overload such as abdominal distension or discomfort, increased appetite is not a primary therapeutic effect of spironolactone.