Final answer:
The nurse should primarily monitor for elevated serum potassium levels in a client taking spironolactone. Additionally, monitoring the patient's blood pressure and for signs of fluid overload is important due to the drug's effects on sodium and water excretion.
Step-by-step explanation:
The nurse is caring for a client who is taking spironolactone, a potassium-sparing diuretic. The nurse should monitor for elevated serum potassium levels. Spironolactone works by blocking the action of aldosterone, which normally causes the kidneys to excrete potassium and reabsorb sodium. By inhibiting aldosterone, spironolactone causes the body to retain potassium and excrete more sodium, potentially leading to hyperkalemia (high potassium levels). It is essential to regularly check the client's serum potassium levels to prevent potential complications associated with excessive potassium.
Since aldosterone also plays a role in managing blood pressure by increasing reabsorption of sodium and water, spironolactone can lead to a decrease in blood pressure. Therefore, the nurse should monitor the patient's blood pressure to ensure it remains within a safe range. Furthermore, by promoting the excretion of sodium and water, the drug can reduce fluid overload, so evidence of fluid overload is an important parameter to monitor.