A nurse is collecting data from a client who reports nausea and has vomited clear emesis. Which of the following medications should the nurse administer?

A. Hypoglycemia. Neither spironolactone nor lisinopril directly affects blood glucose levels. Hypoglycemia is more commonly associated with insulin, sulfonylureas (e.g., glipizide), and excessive alcohol consumption, rather than potassium-sparing diuretics or ACE inhibitors.

B. Hyperkalemia. Spironolactone is a potassium-sparing diuretic that promotes sodium excretion while retaining potassium, increasing the risk of hyperkalemia. Lisinopril, an ACE inhibitor, also raises potassium levels by reducing aldosterone secretion, which normally promotes potassium excretion. The combination of these two medications significantly increases the risk of dangerously high potassium levels, which can lead to cardiac arrhythmias, muscle weakness, and life-threatening complications. Clients should have serum potassium levels monitored regularly and be advised to avoid potassium-rich foods and supplements.

C. Hyperglycemia. Neither medication is known to cause hyperglycemia. Thiazide and loop diuretics are more likely to elevate blood glucose levels due to their effects on insulin sensitivity, but spironolactone and lisinopril do not share this effect.

D. Hypokalemia. Spironolactone prevents potassium loss, and lisinopril reduces potassium excretion, making hypokalemia unlikely. Hypokalemia is more commonly seen with loop diuretics (e.g., furosemide) and thiazide diuretics (e.g., hydrochlorothiazide), which promote potassium loss.

A. Tingling sensation. A mild tingling or paresthesia is a common side effect of sumatriptan due to its vasoconstrictive action. While it should be monitored, it is not typically harmful and does not require immediate medical intervention.

B. Hypertension. Sumatriptan works by constricting blood vessels to relieve migraine symptoms, but it can also cause a dangerous increase in blood pressure. Severe hypertension can lead to complications such as stroke or myocardial infarction. This is the priority finding that requires immediate reporting to prevent life-threatening cardiovascular events.

C. Dizziness. Dizziness can occur due to sumatriptan’s vasoconstrictive properties or from the migraine itself. While it can be uncomfortable, it is not an immediate threat to the client’s safety unless it is severe or associated with other neurological symptoms.

D. Flushing. Facial flushing is a known side effect of sumatriptan and is generally harmless. It occurs due to transient vasodilation in the skin and does not indicate a serious adverse reaction. Monitoring is appropriate, but it does not require urgent intervention.