A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?

Choice A reason: Zidovudine, a nucleoside reverse transcriptase inhibitor, commonly causes bone marrow suppression, leading to anemia, neutropenia, or thrombocytopenia. It inhibits DNA synthesis in rapidly dividing bone marrow cells, reducing red blood cell, white blood cell, and platelet production. Monitoring complete blood counts is essential to detect these hematologic toxicities early and manage them appropriately. Choice B reason: Metabolic alkalosis is not a known adverse effect of zidovudine. The drug primarily affects hematopoiesis and mitochondrial function, not acid-base balance. Metabolic alkalosis may occur in conditions like excessive vomiting or diuretic use, but zidovudine’s mechanism does not alter bicarbonate or pH levels, making this an unlikely complication. Choice C reason: Hypoglycemia is not associated with zidovudine. The drug’s primary toxicities involve bone marrow and mitochondrial dysfunction, not glucose metabolism. Hypoglycemia may occur with other conditions or medications, like insulin, but zidovudine does not affect pancreatic function or glucose regulation, so monitoring for this is unnecessary in this context. Choice D reason: Hyperkalemia is not a recognized side effect of zidovudine. The drug’s adverse effects center on hematologic and muscular systems, not electrolyte balance. Hyperkalemia may result from renal dysfunction or other medications, but zidovudine does not disrupt potassium homeostasis, so it is not a priority for monitoring in this patient.