A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?

A. Decreased chloride level: While electrolyte shifts occur with diuretics, chloride is not the primary electrolyte monitored for therapeutic effect or toxicity in spironolactone therapy compared to sodium and potassium. B. Decreased potassium level: Spironolactone is a potassium-sparing diuretic. Unlike loop diuretics (like furosemide) that flush out potassium, spironolactone blocks aldosterone, causing the body to retain potassium. Therefore, the nurse would monitor for increased potassium (hyperkalemia), not decreased. C. Decreased phosphate level: Spironolactone does not significantly affect phosphate metabolism. D. Decreased sodium level: Spironolactone works by antagonizing (blocking) aldosterone in the kidneys. Aldosterone's normal job is to keep sodium and water in the body and throw potassium out. By blocking it, the body excretes sodium and water (reducing the ascites) but retains potassium. Therefore, a side effect or expected finding can be hyponatremia (low sodium).