A nurse is educating a client who has heart failure about the effects of diuretics on fluid and electrolyte balance. The nurse should instruct the client to report which of the following symptoms to the provider?

Choice A reason:

Decreased skin turgor is a sign of dehydration because the skin loses elasticity when the body loses water. The nurse can assess this by pinching the skin on the back of the hand or the forehead and observing how quickly it returns to its normal position. If it takes longer than a few seconds, it indicates decreased skin turgor.

Choice B reason:

Increased heart rate is a sign of dehydration because the heart has to work harder to pump blood when the blood volume is low. The body also tries to compensate for the fluid loss by increasing the heart rate and constricting the blood vessels.

Choice C reason:

Crackles in the lungs are not a sign of dehydration, but rather a sign of fluid overload or pulmonary edema. Crackles are caused by fluid accumulation in the alveoli, which interferes with gas exchange and produces a crackling sound when breathing. This choice is incorrect.

Choice D reason:

Low urine output is a sign of dehydration because the kidneys try to conserve water by producing less urine. The urine also becomes more concentrated and darker in color when the body is dehydrated.

Choice E reason:

Dry mucous membranes are a sign of dehydration because the body loses moisture from the mouth, nose, and eyes when it is dehydrated. The nurse can assess this by looking at the lips, tongue, and oral cavity for dryness and cracking.

Choice A reason:

Muscle weakness is a symptom of hypokalemia, which is a low level of potassium in the blood. Potassium is an important electrolyte that helps regulate the function of the heart and muscles. Diuretics can cause potassium loss through increased urine output, which can lead to hypokalemia. Hypokalemia can affect the heart rhythm and cause muscle cramps, weakness, fatigue, and constipation. Therefore, the client should report muscle weakness to the provider as it may indicate a need for potassium supplementation or a change in diuretic therapy.

Choice B reason:

Nausea and vomiting are not specific symptoms of diuretic use or fluid and electrolyte imbalance. They can be caused by many other factors, such as infection, food poisoning, medication side effects, or psychological stress. Nausea and vomiting can also lead to dehydration and electrolyte imbalance if not treated promptly. Therefore, the client should drink plenty of fluids and seek medical attention if nausea and vomiting persist or are severe, but they are not directly related to diuretic use or heart failure.

Choice C reason:

Headache and blurred vision are not common symptoms of diuretic use or fluid and electrolyte imbalance. They can be caused by many other factors, such as high blood pressure, migraine, eye strain, or neurological disorders. Headache and blurred vision can also be signs of a serious condition, such as stroke or brain tumor, that requires immediate medical attention. Therefore, the client should report headache and blurred vision to the provider as soon as possible, but they are not directly related to diuretic use or heart failure.

Choice D reason:

Constipation and abdominal pain are not common symptoms of diuretic use or fluid and electrolyte imbalance. They can be caused by many other factors, such as dietary changes, lack of fiber, medication side effects, or bowel obstruction. Constipation and abdominal pain can also be signs of a serious condition, such as appendicitis or diverticulitis, that requires immediate medical attention. Therefore, the client should report constipation and abdominal pain to the provider as soon as possible, but they are not directly related to diuretic use or heart failure.