A nurse is collecting data from a client who has hyperparathyroidism and is receiving 0.9% sodium chloride via IV infusion. Which of the following manifestations should the nurse identify as an adverse effect of the treatment?

A. Kussmaul respirations: Rapid, deep respirations can indicate metabolic acidosis, which may occur if the client develops fluid overload or electrolyte imbalances from IV sodium chloride infusion. Monitoring for respiratory changes helps identify early complications of aggressive fluid therapy in clients with hyperparathyroidism. B. Chvostek's sign: This is a manifestation of hypocalcemia, not a typical adverse effect of sodium chloride infusion. Clients with hyperparathyroidism generally have elevated calcium levels, so Chvostek’s sign would be unlikely in this context. C. Hyperthermia: Elevated body temperature is not a known complication of 0.9% sodium chloride infusion. Fever would more likely indicate infection or another unrelated process rather than a direct effect of IV therapy. D. New onset of hearing loss: Hearing loss is not associated with isotonic saline administration. While severe hypercalcemia can rarely affect auditory function, normal IV sodium chloride therapy does not directly cause ototoxicity.