Final answer:
The nurse should report findings of renal impairment, severe hypokalemia, pronounced anemia, or serious infusion reactions promptly to the healthcare provider when a client is receiving amphotericin B for pulmonary coccidioidomycosis.
Step-by-step explanation:
A client receiving amphotericin B for pulmonary coccidioidomycosis and HIV should be closely monitored due to the potential for serious side effects of amphotericin B. Toxic effects of this antifungal drug can include renal toxicity, hypokalemia, anemia, and infusion reactions like fever and chills. If the nurse observes signs of renal impairment (such as decreased urine output, increased serum creatinine), severe hypokalemia (weakness, cramping, arrhythmias), pronounced anemia (fatigue, pallor), or serious infusion reactions, they should promptly report these findings to the healthcare provider. Amphotericin B is known to impact fungal cell membranes as well as host cells, so the risk of side effects should always be weighed against the benefits of treatment. The patient may also require maintenance therapy with fluconazole to ensure complete clearance of the fungal infection.