Medical Surgical Liver Cirrhosis #2

Question

The nurse provides care for a client who is diagnosed with cirrhosis of the liver. The client’s abdominal girth is significantly larger than the previous two days, and the diuretic spironolactone is prescribed by the health care provider. The nurse will monitor for which drug-related adverse effect?

Answers

  1. Hypokalemia
    • Rationale:

      Because spironolactone is a potassium-sparing diuretic, hypokalemia (i.e., decreased serum potassium) is not an expected drug-related adverse effect.

  2. Hyperglycemia
    • Rationale:

      Spironolactone does not impact serum glucose levels; therefore, hyperglycemia is not an expected drug-related adverse effect. Spironolactone is a potassium-sparing diuretic and clients taking it should be monitored for hyperkalemia.

  3. Hyperkalemia
    • Rationale:

      Spironolactone is the diuretic of choice for treating ascites. Because it is a potassium-sparing diuretic, the nurse monitors the client for hyperkalemia.

  4. Hyperlipidemia
    • Rationale:

      Hyperlipidemia is not a documented drug-related adverse effect when spironolactone is administered for the treatment of ascites. Spironolactone is a potassium-sparing diuretic and clients taking it should be monitored for hyperkalemia.

Overview

Ascites is most commonly treated with a diuretic, which removes the fluid from the abdomen.

Explanation

Learning Outcomes

Spironolactone is the drug of choice in the initial treatment of ascites due to cirrhosis. The initial dose should start at 100 mg/day which is gradually increased until adequate natriuresis (i.e., the excretion of sodium in the urine) is achieved. Spironolactone is a potassium-sparing diuretic and clients taking it should be monitored for hyperkalemia. Cardiac involvement may occur because of hyperkalemia.

Test Taking Tip

Consider the effect that this medication has on serum electrolytes to answer this question correctly.

Video Rationale