A nurse is preparing to directly admit a client from the provider's office and is reviewing their electronic medical record. When assessing the client, which of the following findings should the nurse expect? Select all that apply.

The client is showing signs of hyperkalemia, likely related to potassium-sparing effects of Spironolactone. Spironolactone reduces potassium excretion in the kidneys, leading to elevated serum potassium levels. Hyperkalemia affects neuromuscular function and cardiac conduction, which is reflected in ECG changes such as peaked T waves and absent P waves. Clinical manifestations often involve muscle and nerve irritability and may progress to life-threatening dysrhythmias if untreated. Rationale: A. Muscle weakness is expected because elevated potassium levels interfere with normal neuromuscular transmission. Hyperkalemia reduces the resting membrane potential of cells, making muscle contraction less effective. Clients may report generalized weakness, heaviness in limbs, or difficulty moving muscles. This is a common early neuromuscular sign of potassium toxicity. B. Tingling sensations in the hands (paresthesia) are expected due to altered nerve conduction from elevated serum potassium. Hyperkalemia disrupts normal neuronal excitability, leading to abnormal sensory perceptions such as numbness or tingling in the extremities. These neurologic symptoms often precede more severe complications such as paralysis or cardiac arrhythmias. C. Elevated temperature is not associated with hyperkalemia. Potassium imbalance primarily affects cardiac and neuromuscular systems rather than thermoregulation. Fever would suggest infection or inflammatory processes rather than electrolyte disturbances. D. Bladder distension is not a typical finding of hyperkalemia or spironolactone therapy. While some medications or neurologic conditions can impair bladder function, elevated potassium levels do not directly affect urinary retention. E. Loose stools are associated with hyperkalemia. Whereas increased gastrointestinal motility and diarrhea can actually contribute to potassium loss rather than elevation, High potassium levels increase gastrointestinal motility, frequently resulting in diarrhea, hyperactive bowel sounds, and abdominal cramping. F. Double vision is not a characteristic symptom of hyperkalemia. Visual disturbances are more commonly associated with neurologic or ophthalmic disorders rather than electrolyte imbalances. Hyperkalemia primarily affects skeletal and cardiac muscle function rather than cranial nerve control of vision.