A nurse is assisting with a presentation about caring for clients who are receiving diuretic therapy. The nurse should explain that which of the following medications can put clients at risk for hyperkalemia?

A. Moist mucous membranes: Moist mucous membranes are typically a sign of good hydration and are not usually associated with end-of-life stages. In fact, patients nearing the end of life often experience dryness of the mouth and mucous membranes due to decreased fluid intake and certain medications. This dryness can lead to discomfort and difficulties in swallowing or speaking, which is why oral care is an important part of end-of-life care.

B. Irregular respirations: This is correct. As the body’s systems start to shut down in the final stages of life, irregular respirations, including periods of rapid breathing and pauses (Cheyne-Stokes respirations), can be a common symptom. This happens because the body can no longer effectively remove carbon dioxide, and the automatic process of breathing becomes less coordinated. This can be distressing to witness, but it’s usually not uncomfortable for the patient.

C. Tachycardia: While some patients may experience changes in heart rate, tachycardia is not typically a consistent finding in patients at the end of life. As the body weakens, the heart has to work harder to pump blood, which can sometimes lead to a faster heart rate. However, as the end of life approaches, the heart rate often slows down, and blood pressure decreases.

D. Hypertension: Hypertension, or high blood pressure, is not typically a symptom associated with end-of-life care. In the final stages of life, the body’s systems begin to slow down, and blood pressure often decreases. This is due to a combination of factors, including a slower heart rate and a decrease in the body’s ability to regulate blood pressure. It’s also worth noting that pain, anxiety, and certain medications can temporarily increase blood pressure, even in the end-of-life stages.

A. Abuse:

Abuse typically involves intentional harm or mistreatment of another person. In this scenario, the nurse's error was inadvertent, not intentional, so it does not constitute abuse.

B. Battery:

Battery involves intentional harmful or offensive contact with another person without their consent. The inadvertent medication error in this scenario does not involve intentional contact or harm, so it does not constitute battery.

C. Assault:

Assault involves intentionally threatening or causing fear of immediate harm or offensive contact with another person. The inadvertent medication error, while resulting in harm, was not intentional or intended to cause fear, so it does not constitute assault.

D. Malpractice:

Malpractice refers to professional negligence or failure to adhere to the standard of care expected in one's professional duties, resulting in harm to a patient. In this scenario, the nurse's inadvertent medication error constitutes malpractice because it involved a breach of the standard of care expected in medication administration, resulting in harm to the client.