A client with heart failure (HF), who is taking furosemide, reports having muscle cramps and weakness in the lower extremities. Which action should the nurse implement?

A. Stretch the foot into dorsiflexion: Dorsiflexion of the foot may help temporarily relieve a muscle cramp by stretching the affected muscle group, particularly the gastrocnemius. However, this action only treats the symptom and does not address the underlying cause. In a client taking furosemide, muscle cramps and weakness may indicate electrolyte imbalance. B. Encourage the use of salt with meals: Increasing sodium intake is generally contraindicated in clients with heart failure because excess sodium promotes fluid retention and worsens volume overload. Encouraging salt consumption would therefore conflict with standard dietary management for heart failure and would not address the likely cause of the client’s symptoms. C. Restrict potassium rich foods: Furosemide is a loop diuretic that promotes the renal excretion of potassium, increasing the risk of hypokalemia. Restricting potassium-rich foods would further decrease potassium levels and potentially worsen symptoms such as muscle weakness, cramps, and cardiac dysrhythmias. Potassium restriction would therefore be inappropriate. D. Collect blood for serum electrolytes: Loop diuretics such as furosemide increase urinary loss of potassium, sodium, and magnesium, which can lead to electrolyte disturbances. Symptoms such as muscle cramps and weakness are classic manifestations of hypokalemia or other electrolyte imbalances. Obtaining serum electrolyte levels allows the nurse to confirm the imbalance and guide appropriate treatment, e.g potassium replacement or medication adjustment.