A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

Choice A reason: Vaginal cultures are not necessary for oral contraceptive therapy. They are used to diagnose infections such as bacterial vaginosis, yeast infection, or sexually transmitted diseases.

Choice B reason: Complete blood count is not essential for oral contraceptive therapy. It is used to measure the number and types of blood cells, such as red blood cells, white blood cells, and platelets.

Choice C reason: Serum potassium level is the most important laboratory test for oral contraceptive therapy. This is because some oral contraceptives can increase the risk of hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can cause serious complications such as cardiac arrhythmias, muscle weakness, and paralysis.

Choice D reason: Pregnancy test is not a laboratory test, but a urine test. It is important to rule out pregnancy before starting oral contraceptive therapy, but it is not the most important test for the nurse to assess.

Choice A reason: This is incorrect because drowsiness is not a common or serious adverse effect of alendronate. However, the client should avoid driving or operating machinery if they experience drowsiness.

Choice B reason: This is incorrect because tachycardia is not a common or serious adverse effect of alendronate. However, the client should monitor their pulse and blood pressure regularly and report any abnormal changes to the provider.

Choice C reason: This is correct because jaw pain can indicate a rare but serious condition called osteonecrosis of the jaw, which is associated with alendronate use. The client should report any jaw pain, swelling, or infection to the provider immediately and avoid dental procedures while taking alendronate.

Choice D reason: This is incorrect because dizziness is not a common or serious adverse effect of alendronate. However, the client should rise slowly from a lying or sitting position to prevent orthostatic hypotension and falls.

Choice E reason: This is correct because esophageal erosion can occur if alendronate is not taken correctly. The client should take alendronate with a full glass of water, at least 30 minutes before any food or drink, and remain upright for at least 30 minutes after taking it. The client should report any difficulty swallowing, chest pain, or heartburn to the provider.