A client is taking furosemide (Lasix) for management of mild hypertension. The nurse knows to assess laboratory results for a side effect of this diuretic. Select the lab value that matches a common side effect of this medication.

Choice A reason: Cushing's syndrome is caused by excess cortisol, a type of glucocorticoid hormone, in the body. This can result from overproduction of cortisol by the adrenal glands, or from prolonged use of corticosteroid medications. Elevated glucocorticoid level is the correct alteration in endocrine function for this condition.

Choice B reason: Decreased aldosterone level is not related to Cushing's syndrome. Aldosterone is another hormone produced by the adrenal glands, but it regulates the balance of sodium and potassium in the body. Decreased aldosterone level can cause low blood pressure, dehydration, and electrolyte imbalance.

Choice C reason: Elevated aldosterone secretion is also not related to Cushing's syndrome. Elevated aldosterone secretion can cause high blood pressure, fluid retention, and hypokalemia (low potassium level). This condition is known as hyperaldosteronism or Conn's syndrome.

Choice D reason: Diminished glucocorticoid level is the opposite of Cushing's syndrome. Diminished glucocorticoid level can cause low blood sugar, fatigue, weight loss, and poor stress response. This condition is known as Addison's disease or adrenal insufficiency.

Choice A reason: Patient stopped taking the medication 2 days ago is the most important information to report to the health care provider. Prednisone is a corticosteroid medication that suppresses the immune system and reduces inflammation. Prednisone also affects the production of cortisol, a hormone that regulates the stress response, blood pressure, blood sugar, and metabolism. Prednisone should not be stopped abruptly, as this can cause adrenal insufficiency, a condition where the adrenal glands cannot produce enough cortisol. Adrenal insufficiency can cause symptoms such as fatigue, weakness, nausea, vomiting, low blood pressure, and hypoglycemia. The patient should be instructed to resume taking the prednisone and taper the dose gradually under the supervision of the health care provider.

Choice B reason: Patient has not been taking the prescribed vitamin D is not as important as choice A, but still requires further education by the nurse. Vitamin D is a fat-soluble vitamin that helps the body absorb calcium and phosphorus, and maintain bone health. Prednisone can interfere with the metabolism of vitamin D and cause bone loss, osteoporosis, and fractures. The patient should be advised to take the prescribed vitamin D supplement and eat foods rich in vitamin D, such as fatty fish, egg yolks, cheese, and fortified milk.

Choice C reason: Patient has bilateral 2+ pitting ankle edema is not as critical as choice A, but still needs to be monitored by the nurse. Ankle edema is swelling of the ankles due to fluid accumulation in the tissues. Prednisone can cause ankle edema by increasing the sodium and water retention in the body, and reducing the potassium excretion by the kidneys. The patient should be assessed for signs of fluid overload, such as weight gain, shortness of breath, and crackles in the lungs. The patient should also be encouraged to limit the intake of salt and fluids, and elevate the legs when sitting or lying down.

Choice D reason: Patient's blood pressure is 148/94 mm Hg is not as urgent as choice A, but still needs to be addressed by the nurse. Blood pressure is the force of blood against the walls of the arteries. Prednisone can increase the blood pressure by stimulating the renin-angiotensin-aldosterone system, a hormonal system that regulates the blood volume and pressure. The patient should be advised to check the blood pressure regularly, and report any readings above 140/90 mm Hg to the health care provider. The patient should also be counseled to follow a healthy lifestyle, such as exercising, quitting smoking, reducing stress, and eating a balanced diet low in sodium, fat, and cholesterol.