Question

a nurse is caring for a client who has a new prescription for spironolactone. which of the following laboratory results should the nurse monitor while the client is taking this medication?

potassium level
wbc count
protein level
adrenocorticotropic hormone level

Explanation:

Identify the drug class and mechanism

The client has a new prescription for spironolactone. Spironolactone is a potassium-sparing diuretic that acts as an aldosterone antagonist in the distal renal tubules.

Determine the physiological effect on electrolytes

By blocking aldosterone, spironolactone promotes sodium and water excretion while retaining potassium. This mechanism puts the client at a high risk for developing hyperkalemia (elevated serum potassium levels).

Establish clinical monitoring priorities

Using the Nursing Assessment knowledge point, the nurse must prioritize monitoring laboratory values that are directly affected by the medication's therapeutic and adverse profiles. Because hyperkalemia can lead to life-threatening cardiac dysrhythmias, monitoring the serum potassium level is the critical priority.

Evaluate the other options

• WBC count: Spironolactone does not typically affect white blood cell counts.
• Protein level: Spironolactone does not directly alter serum protein levels.
• Adrenocorticotropic hormone (ACTH) level: Although spironolactone is an aldosterone antagonist, routine monitoring of ACTH is not indicated for clients taking this medication.

Answer:

• (A) Potassium level (Correct answer)
• (B) WBC count
• (C) Protein level
• (D) Adrenocorticotropic hormone level