A nurse is monitoring a client who has just had a thoracentesis to remove pleural fluid. Which of the following clinical manifestations should indicate to the nurse the client is experiencing a complication and the provider should be notified immediately?

Choice A reason: The correct answer is a because hyperkalemia, or high serum potassium levels, often leads to peaked T waves on an ECG. A reduction of T wave amplitude indicates that potassium levels are decreasing and the medication is effective.

Choice B reason: P wave duration is not typically affected by hyperkalemia. Changes in the P wave are more commonly associated with atrial abnormalities, not electrolyte imbalances.

Choice C reason: Widening of the QRS complex is a sign of severe hyperkalemia and indicates worsening of the condition. The goal of treatment is to prevent such changes, not to observe them as an indication of effectiveness.

Choice D reason: Restoration of QRS complex amplitude is not a specific indicator of hyperkalemia or its treatment. The focus should be on changes in the T wave and other signs of electrolyte normalization.

Choice A reason: Black-colored stools can indicate gastrointestinal bleeding, which is a potential side effect of corticosteroids like betamethasone. It is not considered harmless and should be reported to the healthcare provider immediately.

Choice B reason: A low-potassium diet is not specifically required for clients taking betamethasone. Corticosteroids can cause potassium loss, so it is important to monitor potassium levels, but not necessarily restrict intake unless directed by the healthcare provider.

Choice C reason: The correct answer is c because taking corticosteroids like betamethasone every other day can help reduce the risk of adrenal suppression, a common side effect of long-term corticosteroid use. This dosing schedule allows the adrenal glands to recover and maintain their function.

Choice D reason: Taking betamethasone before bedtime is not specifically recommended for its effectiveness. The dosing schedule should be based on the healthcare provider's instructions and tailored to the client's condition and response to the medication.