A patient taking a thiazide diuretic reports muscle cramps. What should the nurse do?

Choice A rationale Increasing fluid intake is not the appropriate action for muscle cramps caused by a thiazide diuretic. Thiazide diuretics, such as hydrochlorothiazide, work by inhibiting sodium and chloride reabsorption in the distal convoluted tubule. This increases water excretion. The muscle cramps are related to electrolyte imbalances, not a lack of hydration. Choice B rationale Discontinuing the medication immediately is not the first step and requires a provider's order. The nurse's initial action should be to gather data to confirm the cause of the cramps. If the cramps are related to hypokalemia, discontinuing the medication without provider consultation could lead to other complications and is not within the nurse's scope of practice. Choice C rationale Thiazide diuretics cause the excretion of sodium, chloride, and potassium from the kidneys, leading to hypokalemia. The normal potassium range is 3.5 to 5.0 mEq/L. Muscle cramps are a classic symptom of hypokalemia. The nurse should check the patient's serum potassium levels to confirm the suspected electrolyte imbalance and inform the provider for further management, such as a potassium supplement. Choice D rationale While regular exercise is beneficial for overall health, encouraging more exercise would not address the underlying cause of the muscle cramps related to the medication's effect on electrolytes. In fact, intense exercise could worsen the situation by causing further fluid and electrolyte loss through sweating.