A nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. The nurse should inform the client that which of the following is a therapeutic effect of this medication?

Choice A reason: Hypokalemia is a low level of potassium in the blood. Furosemide is a loop diuretic that increases the excretion of water and electrolytes, including potassium. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and digoxin toxicity.

Choice B reason: Hypoglycemia is a low level of glucose in the blood. Furosemide does not affect blood glucose levels or insulin secretion. Hypoglycemia may be caused by other factors such as diabetes medications, fasting, or alcohol intake.

Choice C reason: Weight gain is not an adverse effect of furosemide. Furosemide causes weight loss by reducing fluid retention and edema. Weight gain may be a sign of worsening heart failure or fluid overload.

Choice D reason: Increased blood pressure is not an adverse effect of furosemide. Furosemide lowers blood pressure by decreasing blood volume and cardiac preload. Increased blood pressure may be caused by other factors such as salt intake, stress, or kidney disease.

The correct answer is a. Alcohol.

Choice A: Alcohol

Reason: Alcohol can significantly affect blood glucose levels in patients taking glimepiride. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur depending on the amount and frequency of alcohol consumption. Alcohol can enhance the blood sugar-lowering effect of glimepiride, leading to a dangerous drop in blood sugar levels, known as hypoglycemia. Symptoms of hypoglycemia include dizziness, confusion, weakness, and in severe cases, loss of consciousness. Therefore, it is advised to avoid alcohol while taking glimepiride.

Choice B: Milk

Reason: There are no known interactions between glimepiride and milk. Milk does not affect the absorption or efficacy of glimepiride. Therefore, it is generally safe to consume milk while taking this medication.

Choice C: Grapefruit juice

Reason: Grapefruit juice might theoretically increase the levels of drugs metabolized by CYP2C9, including glimepiride, due to its potential to inhibit CYP2C9 enzymes. However, this interaction has not been reported in humans and is considered unlikely to have a significant clinical impact. Therefore, grapefruit juice is not a major concern for patients taking glimepiride.

Choice D: Coffee

Reason: Coffee and other caffeinated beverages may increase blood sugar levels, which can counteract the effects of glimepiride. However, this interaction is not as significant as the interaction with alcohol. It is generally advised to monitor blood sugar levels and consume coffee in moderation while taking glimepiride.