A nurse is caring for a 62-year-old female client on a medical-surgical unit. Complete the following sentence by using the lists of options. The client is at risk for ________ due to _________.

The client is at risk for hypotension due to hydrochlorothiazide. Rationale for correct answers: Hydrochlorothiazide is a thiazide diuretic that reduces blood volume by promoting renal excretion of sodium and water, which lowers blood pressure. This mechanism can lead to hypotension, especially in postoperative patients with fluid shifts or concurrent antihypertensive therapy. Normal blood pressure is approximately 120/80 mm Hg, and this client’s current blood pressure of 92/75 mm Hg indicates mild hypotension, likely related to the diuretic effect of hydrochlorothiazide. Rationale for incorrect Response 1 options: Hypoglycemia is a low blood glucose state (below 70 mg/dL) often caused by excess insulin or insufficient food intake, but hydrochlorothiazide typically does not cause hypoglycemia. Instead, it can sometimes increase glucose levels due to altered insulin sensitivity. Hyperkalemia (elevated potassium >5.0 mEq/L) is unlikely because thiazides promote potassium excretion, tending toward hypokalemia rather than hyperkalemia. Infection risk is unrelated to hydrochlorothiazide use and would be influenced more by surgery or immune status. Rationale for incorrect Response 2 options: Insulin glargine is a long-acting insulin primarily influencing blood glucose, not blood pressure. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can cause renal impairment and fluid retention but does not directly cause hypotension. Glucose level is a lab value, not a medication or intervention that causes hypotension. Take home points: Hydrochlorothiazide can cause hypotension through volume depletion and natriuresis. Blood pressure monitoring is essential in postoperative patients on diuretics. Differentiate drug-induced hypotension from other causes such as bleeding or sepsis. Understand that thiazides can increase blood glucose and decrease potassium levels, influencing diabetic management.