A patient who has heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in the lungs. The nurse understands that these symptoms are the result of

Choice A reason: Furosemide, a loop diuretic, reduces blood volume, often lowering blood pressure. Monitoring for hypotension is critical to prevent dizziness or shock, making this the correct manifestation to observe.

Choice B reason: Decreased temperature is not a common effect of furosemide, which primarily affects fluid balance. Blood pressure changes are more relevant, so this is incorrect.

Choice C reason: Furosemide may increase heart rate due to volume loss, not decrease pulse. Hypotension is a primary concern, making this incorrect for the expected manifestation.

Choice D reason: Decreased respiratory rate is unrelated to furosemide, which may improve breathing in heart failure but not slow respiration. Blood pressure is key, so this is incorrect.

Choice A reason: A sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). While furosemide can cause hyponatremia, this value is not concerning. Hypokalemia is a greater risk with furosemide and digoxin, as it potentiates digoxin toxicity, making this choice less critical than potassium.

Choice B reason: Oxygen saturation of 95% is normal (95-100%). Crackles suggest pulmonary edema, but this saturation doesn’t indicate severe hypoxia requiring immediate action. Hypokalemia poses a greater risk with digoxin and furosemide, as it increases toxicity potential, making this choice less concerning.

Choice C reason: A potassium level of 3.0 mEq/L (normal: 3.5-5.0 mEq/L) indicates hypokalemia, exacerbated by furosemide’s diuretic effect. In digoxin use, low potassium increases cardiac toxicity risk, causing arrhythmias, especially with an irregular heart rate noted, making this the most concerning value requiring immediate attention.

Choice D reason: A blood glucose level of 100 mg/dL is normal (70-110 mg/dL fasting). It’s unrelated to digoxin or furosemide’s primary risks (e.g., electrolyte imbalances, arrhythmias). Hypokalemia is a more immediate concern due to its synergistic toxicity with digoxin, making this choice less critical.