A nurse is caring for a client with edema due to congestive heart failure (CHF). The primary health ...

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Clients receiving a diuretic, particularly a loop or thiazide diuretic such as indapamide, and a digitalis glycoside concurrently require frequent monitoring of the pulse rate and rhythm because of the possibility of cardiac arrhythmias. Any significant changes in the pulse rate and rhythm are immediately reported to the primary health care provider. The nurse should encourage oral fluids at frequent intervals during waking hours when caring for older clients to prevent a fluid volume deficit. In such cases the nurse should also encourage elderly clients to eat or drink between meals and in the evening. The nurse must closely observe clients receiving a potassium-sparing diuretic for signs of hyperkalemia, a serious and potentially fatal electrolyte imbalance.