A nurse is teaching a client who has a diagnosis of heart failure about furosemide.
Which of the following instructions should the nurse include in the teaching about this medication? Select all that apply.

Choice A rationale

Bronchospasm is a constriction of the airways, commonly seen in respiratory conditions like asthma. It is mediated by inflammatory responses and smooth muscle contraction in the bronchi. Acetazolamide, a carbonic anhydrase inhibitor, does not typically cause bronchospasm; its primary effects are on fluid and electrolyte balance and intraocular pressure.

Choice B rationale

Constipation is a common gastrointestinal symptom characterized by infrequent or difficult bowel movements. It can be caused by various factors, including dietary habits, medications, and underlying medical conditions. Acetazolamide's mechanism of action, involving inhibition of carbonic anhydrase, does not directly lead to constipation as a significant adverse effect.

Choice C rationale

Diplopia, or double vision, is a visual disturbance where a single object appears as two. It can result from ocular muscle weakness, nerve damage, or other neurological conditions. Acetazolamide's therapeutic effects are on aqueous humor production in the eye to reduce intraocular pressure, but diplopia is not a recognized adverse effect of this medication.

Choice D rationale

Acetazolamide is a carbonic anhydrase inhibitor that promotes the excretion of bicarbonate, sodium, potassium, and water. This diuretic action can lead to metabolic acidosis, hypokalemia (normal range: 3.5-5.0 mEq/L), and hyponatremia (normal range: 135-145 mEq/L) due to increased renal excretion, hence requiring close monitoring of electrolyte balance.

Choice A rationale

Androgen therapy can lead to fluid retention, which would typically cause weight gain rather than weight loss. Androgens promote anabolism and can increase muscle mass and erythrocyte production, but they also influence fluid balance by affecting renal sodium and water reabsorption.

Choice B rationale

Androgen therapy generally does not cause hypotension. In some cases, it may lead to a slight increase in blood pressure due to fluid retention and effects on the renin-angiotensin-aldosterone system. Hypotension is not a recognized common adverse effect of androgen therapy.

Choice C rationale

Androgen therapy does promote muscle hypertrophy due to its anabolic effects, increasing protein synthesis and muscle mass. However, this is generally a desired therapeutic effect, not an adverse effect requiring monitoring for cessation, especially when used for conditions like muscle wasting.

Choice D rationale

Androgens can cause fluid retention, leading to edema. This occurs due to their influence on mineralocorticoid receptors in the renal tubules, which promotes sodium and water reabsorption. Nurses should monitor for signs of fluid overload, such as peripheral or pulmonary edema, and changes in body weight.