A nurse is caring for a client that will receive a diuretic.
Which of the following diuretics act on the distal tubule?

Choice A rationale

Gemfibrozil is a fibrate that reduces triglycerides and increases HDL cholesterol, commonly used to treat hyperlipidemia.

Choice B rationale

Simvastatin is a statin that inhibits HMG-CoA reductase, reducing LDL cholesterol levels and is used in managing hyperlipidemia.

Choice C rationale

Enalapril is an ACE inhibitor used to manage hypertension and heart failure, not typically used for hyperlipidemia.

Choice D rationale

Warfarin is an anticoagulant used to prevent blood clots and is not used for treating hyperlipidemia.

Choice E rationale

Fenofibrate is another fibrate like gemfibrozil, used to reduce triglycerides and increase HDL cholesterol, making it an anti-lipemic medication.

Choice A rationale: Furosemide is a loop diuretic used to reduce fluid overload in CHF patients. However, it can exacerbate electrolyte imbalances, particularly hypokalemia. Since the client is already experiencing muscle spasms and has low calcium levels, additional diuretic therapy could worsen these symptoms.

Choice B rationale: Metoprolol is a beta-blocker used to manage hypertension and heart rate in CHF patients. While beneficial for blood pressure control, it does not address the immediate issue of muscle spasms and constipation the client is experiencing.

Choice C rationale: Potassium chloride is indicated to address potential hypokalemia, which may be causing the client's muscle spasms. CHF patients on diuretics often experience low potassium levels, so supplementation is crucial to prevent complications and alleviate symptoms.

Choice D rationale: Acetaminophen is an analgesic and antipyretic, useful for pain and fever management. However, it does not address the client's reported muscle spasms, which are likely related to electrolyte imbalances.