A nurse is assessing a client who is receiving IV furosemide for peripheral edema.
Which of the following findings should the nurse identify as an indication that the client is developing dehydration?

Step 1 is: Convert client weight from pounds to kilograms. 165 Ib ÷ 2.2 Ib/kg = 75 kg.

Step 2 is: Calculate the total dose of verapamil needed. 0.1 mg/kg × 75 kg = 7.5 mg.

Step 3 is: Calculate the volume to administer in mL. 7.5 mg ÷ (2.5 mg/mL) = 3 mL. The nurse should administer 3 mL.

Choice A rationale

Aspartate aminotransferase (AST) is an enzyme primarily found in the liver, heart, and muscle. Elevated levels can indicate hepatocellular damage or cardiac muscle injury. While some medications can affect liver function, AST is not a primary monitoring parameter for methylprednisolone, which is a corticosteroid, unless specific hepatotoxicity is suspected or pre-existing liver conditions exist. Normal AST levels are typically 10-40 U/L.

Choice B rationale

Fibrin split products (FSPs) are indicators of fibrinolysis, the breakdown of fibrin clots. Elevated FSPs suggest active clotting and subsequent clot degradation, often seen in disseminated intravascular coagulation (DIC). Methylprednisolone, a corticosteroid, does not directly impact fibrinolysis or coagulation to warrant routine monitoring of FSPs as a primary concern. This test is not routinely indicated.

Choice C rationale

Blood urea nitrogen (BUN) measures the amount of nitrogen in the blood that comes from the waste product urea. Elevated BUN can indicate kidney dysfunction or dehydration. While corticosteroids can influence fluid balance, BUN is not a specific or primary laboratory value monitored for the direct effects of methylprednisolone therapy unless a pre-existing renal impairment is present. Normal BUN levels are typically 7-20 mg/dL.

Choice D rationale

Methylprednisolone, a glucocorticoid, significantly impacts carbohydrate metabolism by promoting gluconeogenesis and glycogenolysis, leading to increased blood glucose levels. This can induce hyperglycemia and even steroid-induced diabetes, particularly in predisposed individuals. Therefore, close monitoring of blood glucose is crucial to prevent and manage this common adverse effect. Normal fasting glucose is typically 70-99 mg/dL.