The nurse reviews the lab values.

Exhibits

What questions can the nurse ask the client based on the lab results? Select all that apply.

Choice A rationale: Nausea is the symptom the medication is intended to treat, and it is expected that the client may have some level of nausea while undergoing chemotherapy. It is not the most important adverse effect to report in this scenario.

Choice B rationale: Diarrhea is not a common or significant adverse effect of metoclopramide. While it is essential to monitor for any gastrointestinal side effects, it is not the most important adverse effect to report in this case.

Choice C rationale: Metoclopramide is a medication commonly used to treat nausea and vomiting, particularly related to chemotherapy. One of the significant adverse effects of metoclopramide is the potential to cause extrapyramidal symptoms, including involuntary movements such as dystonia, dyskinesia, and Parkinsonism. These extrapyramidal symptoms can be serious and may require immediate intervention or discontinuation of the medication.

Therefore, it is essential for the nurse to closely monitor the client for any signs of involuntary movements and report them promptly to the healthcare provider for appropriate management.

Choice D rationale: Unusual irritability is not a typical adverse effect associated with metoclopramide. While mood changes can occur with any medication, involuntary movements are a more concerning side effect that requires immediate attention and reporting.

Choice A rationale: This instruction is not directly related to spironolactone use or hyperaldosteronism. Excessive bruising may be relevant in some situations but not specifically for this scenario.
Choice B rationale: While heart failure patients are often advised to reduce their sodium intake, the use of a salt substitute (potassium-based) would be contraindicated in this case due to the risk of hyperkalemia.
Choice C rationale: This instruction is not directly related to spironolactone use or
hyperaldosteronism. It may be relevant for sun protection, but it is not a priority in this context.
Choice D rationale: Spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium while excreting sodium and water. Since the client has heart failure (HF), there is a risk of hyperkalemia (high potassium levels) associated with spironolactone use. To prevent this, the nurse should instruct the client to limit their intake of high-potassium foods, such as bananas, oranges, tomatoes, spinach, and other potassium-rich foods.