An older adult patient with congestive heart failure develops crackles in both lungs and pitting edema of all extremities. The physician orders hydrochlorothiazide [HydroDIURIL]
Before ad-ministering this medication, the nurse reviews the patient's chart. Which laboratory value causes the nurse the most concern? a. Elevated creatinine clearance
b. Elevated serum potassium level
c. Normal blood glucose level
d. Low levels of low-density lipoprotein (LDL) cholesterol
A
Hydrochlorothiazide should not be given to patients with severe renal impairment; therefore, an elevated creatinine clearance would cause the most concern. Thiazide diuretics are potas-sium-wasting drugs and thus may actually improve the patient's potassium level. Thiazides may elevate the serum glucose level in diabetic patients. Thiazides increase LDL cholesterol; however, this patient's levels are low, so this is not a risk.
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