The client has just undergone surgery for bladder cancer and has an indwelling urinary catheter.
The nurse should monitor for which of the following complications?

Furosemide is a loop diuretic that causes the kidneys to excrete more water and salt, which can lead to dehydration and electrolyte imbalance.

Electrolyte imbalance can cause muscle cramps, numbness and tingling, weakness and fatigue, and other symptoms.

Therefore, the client should monitor for these signs and report them to the doctor if they occur.

Choice B is wrong because dry mouth is not a sign of electrolyte imbalance, but rather a sign of dehydration.

Dehydration can also cause thirst, decreased urination, drowsiness, and confusion.

Choice E is wrong because tachycardia is not a sign of electrolyte imbalance, but rather a sign of hypovolemia (low blood volume) or hypotension (low blood pressure).

Furosemide can lower blood pressure by reducing fluid volume in the body.

Therefore, the client should also monitor their blood pressure and pulse regularly while taking furosemide.

Choice A reason: This hypotonic saline solution is often used after initial resuscitation, especially when the patient’s serum sodium is normal or elevated. It helps replace intracellular fluid losses and provides ongoing hydration without excessively increasing sodium levels. It is typically administered once the initial intravascular volume is restored with isotonic fluids.

Choice B reason: This isotonic saline solution is the first-line intravenous fluid used in DKA. It helps expand intravascular volume quickly, restore tissue perfusion, and correct hypovolemia caused by osmotic diuresis. It is given initially as a bolus, followed by continuous infusion until the patient is stabilized.

Choice C reason: This dextrose-containing solution is introduced once blood glucose falls to approximately 200–250 mg/dL. At this point, insulin therapy must continue to clear ketones and correct acidosis, but dextrose is added to prevent hypoglycemia. It is usually combined with saline (e.g., D5 0.45% NS) to balance hydration and glucose support.

Choice D reason: This balanced electrolyte solution is not typically the preferred fluid in DKA management because the lactate component may complicate interpretation of acid–base status. Although it can expand volume, it is generally avoided in favor of saline solutions that more directly address dehydration and electrolyte imbalance in DKA.

Choice E reason: This form of insulin is the only type used intravenously in DKA. A continuous infusion of regular insulin is essential to reduce blood glucose, suppress ketone production, and correct metabolic acidosis. It is carefully titrated with close monitoring of electrolytes, especially potassium, since insulin drives potassium into cells and can cause hypokalemia.