A nurse is reviewing a client's laboratory results before administering furosemide 40 mg IV bolus. For which of the following values should the nurse withhold the medication and contact the provider?

Choice A Reason:
Contact the provider to clarify the prescription is not appropriate. Contacting the provider might not be necessary in this case. The prescription specifies "NOW," indicating an urgent administration, which is a clear directive to administer the medication promptly without further clarification.
Choice B Reason:
Administer the medication within 90 minutes is appropriate. "NOW" typically implies an urgent need for administration, and within a hospital setting, "NOW" often indicates a timeframe of around 90 minutes for prompt administration of the medication.
Choice C Reason:
Notify the pharmacy to send the medication immediately is inappropriate. With the prescription stating "NOW," the need for immediate administration usually requires using the hospital's available stock of the medication rather than waiting for delivery from the pharmacy. This action might cause a delay in administration.
Choice D Reason:
Inform the client there is a prescription available if needed is inappropriate. This option is not suitable in this scenario. "NOW" in the prescription implies the immediate need for administration, so informing the client about the availability of the prescription doesn't align with the urgency implied by the directive "NOW."

Choice A Reason:
Hypokalemia is correct. Hydrochlorothiazide is a thiazide diuretic that promotes the excretion of sodium and water in the kidneys, leading to increased urine production. However, it can also cause the loss of potassium (hypokalemia) as a side effect. Hypokalemia can manifest with symptoms such as muscle weakness, fatigue, irregular heart rhythms, and muscle cramps.
Choice B Reason:
Hypermagnesemia is incorrect. Hydrochlorothiazide typically promotes the loss of magnesium rather than causing elevated magnesium levels.
Choice C Reason:
Hypernatremia is incorrect. Hydrochlorothiazide is more likely to cause a decrease in sodium levels (hyponatremia) rather than an increase (hypernatremia).
Choice D Reason:
Hypocalcemia is incorrect. Hydrochlorothiazide can cause increased excretion of calcium but it's not a common adverse effect compared to the loss of potassium (hypokalemia).