A nurse is reviewing a client's medical history and notes a diagnosis of uncontrolled diabetes mellitus. The nurse recognizes this as a significant risk factor for congestive heart failure due to its association with:

A) This choice is incorrect because limiting fluid intake is not specific to the administration of spironolactone. Fluid intake may need to be adjusted based on the client's overall fluid balance and congestive heart failure status, but it is not a direct instruction related to the medication.

B) This choice is correct. Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia (high potassium levels). The client should avoid foods high in potassium to help prevent potassium overload and potential adverse effects.

C) This choice is incorrect because the timing of spironolactone administration may vary depending on the client's individual response and the presence of other medications. The client should follow the prescribed schedule given by the healthcare provider.

D) This choice is incorrect because monitoring blood pressure daily and adjusting the dose accordingly is not specific to the administration of spironolactone. While blood pressure may need to be monitored regularly, dosage adjustments should only be made under the guidance of the healthcare provider.

Questions

A) This choice is correct. Hypertension (high blood pressure) is a significant risk factor for congestive heart failure (CHF). Prolonged hypertension can lead to the heart's increased workload, causing it to weaken over time and eventually leading to CHF. The client's symptoms of fatigue, difficulty breathing, and nocturia (frequent urination at night) are common manifestations of CHF resulting from uncontrolled hypertension.

B) This choice is incorrect because diabetes mellitus, while a risk factor for cardiovascular disease, is not directly associated with the symptoms described by the client. However, diabetes can exacerbate CHF if the client's blood glucose levels are not well-controlled.

C) This choice is incorrect because smoking history is a risk factor for various cardiovascular diseases, but it is not specifically linked to the symptoms reported by the client in this case.

D) This choice is incorrect because a family history of heart disease may increase the client's risk of developing CHF, but it does not directly contribute to the current symptoms the client is experiencing.