A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which imbalance?
1. Hyperkalemia
2. Hypokalemia
3. Hypercalcemia
4. Hypocalcemia
1
Rationale 1: Hyperkalemia is defined as serum potassium level greater than 5.0 mEq/L. Decreased potassium excretion is seen with potassium-sparing diuretics such as spironolactone. Common manifestations of hyperkalemia are muscle weakness and ECG changes.
Rationale 2: Hypokalemia is seen in nonpotassium sparing diuretics such as furosemide.
Rationale 3: Hypercalcemia has been associated with thiazide diuretics.
Rationale 4: Hypocalcemia is seen in patients who have received many units of citrated blood and is not associated with diuretic use.
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