A nurse is preparing to instill 840 mL of enteral nutrition via a client's gastrostomy tube over 24 hr using an infusion pump. The nurse should set the infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)_mL/hr

A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.

B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.

C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.

D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."

A) Decreased bowel sounds:
While diarrhea can lead to changes in bowel function, such as increased frequency and urgency, it typically does not cause decreased bowel sounds. In fact, hyperactive bowel sounds may be present in some cases of diarrhea due to increased gastrointestinal motility and peristalsis as the body attempts to expel excess stool.

B) Dehydration:
This is the correct answer. Diarrhea can result in fluid and electrolyte losses, leading to dehydration if not adequately managed. Common symptoms of dehydration include increased thirst, dry mucous membranes, decreased urine output, dark urine, fatigue, weakness, and dizziness. In severe cases, dehydration can lead to hypovolemic shock, a life-threatening condition requiring immediate medical attention.

C) Rigid abdomen:
While abdominal discomfort and cramping are common symptoms of diarrhea, a rigid abdomen is not typically associated with uncomplicated cases of diarrhea. However, severe abdominal pain, distention, and rigidity may indicate underlying complications such as bowel obstruction or peritonitis, which require urgent medical evaluation.

D) Hypothermia:
Hypothermia, or abnormally low body temperature, is not a typical finding in clients with diarrhea. In fact, diarrhea is more commonly associated with fluid and electrolyte imbalances that can lead to hyperthermia (elevated body temperature) due to dehydration and inflammatory responses. However, hypothermia may occur in severe cases of dehydration or sepsis, but it is not a direct consequence of diarrhea itself.