NCLEX-PN® ExaminationPhysiological AdaptationEasy
A client with a history of heart failure is prescribed furosemide 40 mg PO daily. The nurse should instruct the client to monitor for which of the following electrolyte imbalances as a potential adverse effect?
- AHypernatremia
- BHyperkalemia
- CHypercalcemia
- DHypokalemia
Show answer & explanationAnswer & explanation
Correct answer: D. Hypokalemia
Furosemide is a loop diuretic that works by inhibiting sodium and chloride reabsorption in the loop of Henle, leading to increased excretion of water, sodium, chloride, and importantly, potassium. Therefore, hypokalemia is a common and significant adverse effect.
Why the other options are wrong
- A. Furosemide promotes sodium excretion, so hypernatremia is unlikely; hyponatremia is a more common fluid/electrolyte imbalance.
- B. Furosemide causes potassium excretion, leading to hypokalemia, not hyperkalemia.
- C. Loop diuretics can sometimes increase calcium excretion, potentially leading to hypocalcemia, not hypercalcemia.
Furosemide Electrolyte Imbalance
Furosemide, a loop diuretic, primarily causes the excretion of potassium, leading to hypokalemia. Clients on furosemide require regular monitoring of potassium levels.
- Loop diuretics inhibit reabsorption in the loop of Henle.
- Increases excretion of Na, Cl, K, and water.
- Hypokalemia is a common and serious side effect.
Memory trick: Furosemide's Flow: K+ Goes Low