Spironolactone (Aldactone) is prescribed for a client with chronic cirrhosis and ascites. The nurse should monitor the client for which of the following medication-related side effects?
A. Jaundice
B. Hyperkalemia
C. Tachycardia
D. Constipation
Correct Answer: B. Hyperkalemia
This is a potassium-sparing diuretic so clients should be monitored closely for hyperkalemia. Diarrhea, dizziness, and headaches are other more common side effects. Spironolactone is a medication used in the management and treatment of hypertension and heart failure with some indications aside from cardiovascular disease. It is in the mineralocorticoid receptor antagonist class of drugs.
Option A: Jaundice is not an expected side effect of spironolactone (Aldactone). The most common non-electrolyte and electrolyte adverse effects of spironolactone are breast complaints and hyperkalemia, respectively. Men specifically may experience gynecomastia, loss of libido, and general feminization; the drug is a category C pregnancy drug because animal studies showed that the feminization of male fetuses is a concern.
Option C: Tachycardia is not an expected side effect of spironolactone (Aldactone). Women can experience menstrual irregularities. One study mentions the following additional adverse effects in order from more to less common: dehydration, hyponatremia, gastrointestinal problems (nausea, vomiting, diarrhea or anorexia), neurological abnormalities (headache, drowsiness, asterixis, confusion, or coma), and skin rashes.
Option D: Constipation is not an expected side effect of spironolactone (Aldactone). Hyperkalemia can be due to spironolactone alone or a synergistic side effect from multiple medications such as beta-blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers that clinicians often prescribe to patients for indications such as hypertension or heart failure.
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