A client is admitted for acute renal failure and the nurse is monitoring their response to medications. Which pharmacokinetic principle does the nurse understand will be affected in this patient?

Choice A reason: This statement is false. The client does not need to avoid taking acetaminophen with spironolactone, as there is no known interaction between these two drugs. Acetaminophen is a pain reliever and fever reducer that does not affect the blood clotting or the liver function. Spironolactone is a potassium sparing diuretic that reduces the fluid retention and the blood pressure. It does not increase the risk of bleeding or liver damage.

Choice B reason: This statement is false. The client does not need to report dry cough or blood sugar over 80 with spironolactone, as these are not common or serious side effects of this drug. Dry cough is more likely to occur with angiotensin converting enzyme (ACE) inhibitors, which are another class of blood pressure medications. Blood sugar over 80 is not a sign of hyperglycemia, which is a condition where the blood sugar is too high. Hyperglycemia can be caused by diabetes, steroids, or some other drugs, but not by spironolactone.

Choice C reason: This statement is true. The client should avoid bananas, cantaloupe, and spinach with spironolactone, as these are foods that are high in potassium. Spironolactone is a potassium sparing diuretic that prevents the loss of potassium in the urine. However, it can also cause hyperkalemia, which is a condition where the potassium level is too high. High potassium can cause muscle weakness, irregular heartbeat, or cardiac arrest. Therefore, the client should limit the intake of potassium rich foods and have their blood potassium level checked regularly.

Choice D reason: This statement is false. The client does not need to check their heart rate before each dose of spironolactone, as spironolactone does not affect the heart rate significantly. Spironolactone is a potassium sparing diuretic that reduces the fluid retention and the blood pressure. It can lower the heart rate slightly, but not to a dangerous level. However, the client should monitor their blood pressure and weight regularly and report any changes to their doctor..

Choice A reason: This statement is false. The nurse does not need to assess the client's INR level, as INR stands for international normalized ratio, which is a test that measures the blood clotting time. Glipizide is an oral antidiabetic drug that lowers blood glucose levels by stimulating the release of insulin from the pancreas. It does not affect the blood clotting time or the INR level.

Choice B reason: This statement is false. The nurse does not need to assess the client's last bowel movement, as this is not relevant to the client's condition. Glipizide is an oral antidiabetic drug that lowers blood glucose levels by stimulating the release of insulin from the pancreas. It does not affect the bowel movements or the gastrointestinal function.

Choice C reason: This statement is true. The nurse's priority assessment is to check the client's blood glucose level, as the client may have hypoglycemia, which is a condition where the blood glucose level is too low. Hypoglycemia can cause confusion, sweating, and rapid heart rate, which are the symptoms that the client is experiencing. Hypoglycemia can be a serious and life-threatening complication of glipizide therapy, as it can lead to seizures, coma, or death if not treated promptly.

Choice D reason: This statement is false. The nurse does not need to assess the client's apical heart rate, as this is not the most urgent assessment. Glipizide is an oral antidiabetic drug that lowers blood glucose levels by stimulating the release of insulin from the pancreas. It can also lower the blood pressure and heart rate, but not to a dangerous level. However, the client's tachycardia may be a sign of hypoglycemia, which is a more critical condition that requires immediate intervention..