A nurse is teaching a client who is pregnant and has iron-deficiency anemia about taking ferrous sulfate elixir, Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

A. Hypocalcemia: Hydrochlorothiazide is not typically associated with lowering calcium levels. Hypocalcemia is not a common adverse effect of this medication.
B. Hypernatremia: Hydrochlorothiazide is a diuretic that increases urination, leading to the loss of water and sodium. While it can cause sodium depletion, it's less likely to result in hypernatremia, which refers to high sodium levels in the blood.
C. Hypokalemia: Hydrochlorothiazide is a thiazide diuretic that can increase the excretion of potassium in the urine. Hypokalemia (low potassium levels) is a known adverse effect of this medication due to its action on the kidneys leading to potassium loss.
D. Hypermagnesemia: Hydrochlorothiazide does not typically cause an increase in magnesium levels. It's more likely to cause magnesium loss through increased urination, potentially leading to hypomagnesemia (low magnesium levels) rather than hypermagnesemia.

A. INR 1.0: The International Normalized Ratio (INR) is a measure of blood clotting. A value of 1.0 is within the normal range, so there is no immediate concern related to furosemide administration based on this INR value.
B. WBC count 8,000/mm³: The white blood cell count is not directly related to furosemide administration, and the value of 8,000/mm³ is within the normal range. There is no immediate concern based on this WBC count.
C. Sodium 141 mEq/L: The sodium level is within the normal range, and it is not a contraindication for furosemide administration.
D. Potassium 2.5 mEq/L: A potassium level of 2.5 mEq/L is significantly below the normal range. Furosemide is a loop diuretic that can lead to potassium loss, and administering it when the potassium level is already low can further decrease potassium levels, potentially leading to serious complications such as cardiac arrhythmias. Therefore, the nurse should withhold the medication and contact the provider to address the low potassium level before administering furosemide.