A nurse is caring for a client who has prescriptions for spironolactone and lisinopril. The nurse should monitor for which of the following adverse effects?

A. Hypoglycemia. Neither spironolactone nor lisinopril directly affects blood glucose levels. Hypoglycemia is more commonly associated with insulin, sulfonylureas (e.g., glipizide), and excessive alcohol consumption, rather than potassium-sparing diuretics or ACE inhibitors. B. Hyperkalemia. Spironolactone is a potassium-sparing diuretic that promotes sodium excretion while retaining potassium, increasing the risk of hyperkalemia. Lisinopril, an ACE inhibitor, also raises potassium levels by reducing aldosterone secretion, which normally promotes potassium excretion. The combination of these two medications significantly increases the risk of dangerously high potassium levels, which can lead to cardiac arrhythmias, muscle weakness, and life-threatening complications. Clients should have serum potassium levels monitored regularly and be advised to avoid potassium-rich foods and supplements. C. Hyperglycemia. Neither medication is known to cause hyperglycemia. Thiazide and loop diuretics are more likely to elevate blood glucose levels due to their effects on insulin sensitivity, but spironolactone and lisinopril do not share this effect. D. Hypokalemia. Spironolactone prevents potassium loss, and lisinopril reduces potassium excretion, making hypokalemia unlikely. Hypokalemia is more commonly seen with loop diuretics (e.g., furosemide) and thiazide diuretics (e.g., hydrochlorothiazide), which promote potassium loss.