Question

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication?

a-Hypokalemia
b-Hypomagnesemia
c-Hypernatremia
d-Hyponatremia

Answer 1

The nurse should identify hypokalemia as an adverse effect of hydrochlorothiazide in heart failure patients, as it can lead to significant potassium loss. Hyponatremia is also possible, but less likely. Hypernatremia and hypomagnesemia are not typical adverse effects of thiazide diuretics like hydrochlorothiazide.

Step-by-step explanation:

The nurse should identify hypokalemia as an adverse effect of taking hydrochlorothiazide, especially in older adult clients who have heart failure. Hydrochlorothiazide is a type of diuretic, specifically a thiazide diuretic, that works by inhibiting the reabsorption of sodium (Na+) and chloride (Cl-) ions in the distal convoluted tubule of the kidneys, not the loop of Henle as loop diuretics do. Due to the loss of sodium and water from the body, there's also an increased loss of potassium, which can lead to hypokalemia.

Another potential electrolyte disturbance caused by this medication is hyponatremia, where there is a lower than normal level of sodium in the bloodstream. However, hypernatremia, an elevated level of sodium in the blood, is less likely with hydrochlorothiazide use since the drug promotes the excretion of sodium. While hypomagnesemia, or low magnesium levels, can occur with diuretics, it is more commonly associated with loop diuretics rather than thiazide diuretics like hydrochlorothiazide.