ExhibitsA nurse is reviewing the medical record of a client who has heat exhaustion with nausea and vomiting. Which of the following prescriptions should the nurse administer? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.)

Nursing management of a client with heat exhaustion focuses on restoring fluid balance, correcting electrolyte disturbances, and preventing progression to heat stroke. Heat exhaustion occurs due to excessive fluid and sodium loss through sweating, leading to hypovolemia, tachycardia, hypotension, and concentrated urine. The client’s findings—elevated temperature, orthostatic hypotension, tachycardia, high urine specific gravity, and low urine output—indicate significant dehydration requiring immediate volume replacement. Heat exhaustion Rationale: A. Potassium administration is not appropriate because the client’s potassium level is within normal range (3.6 mEq/L). Administering potassium without indication could lead to hyperkalemia, especially since renal perfusion is already compromised due to dehydration. Potassium replacement should only be given when laboratory values indicate deficiency. B. Administering IV normal saline is the correct intervention because the client is hypovolemic, as evidenced by orthostatic hypotension, tachycardia, elevated temperature, and concentrated urine (specific gravity 1.035). Isotonic fluids restore intravascular volume, improve perfusion, and support renal function. Fluid replacement is the priority in managing heat exhaustion. C. Metoprolol should not be administered because beta-blockers can further lower blood pressure and worsen compensatory tachycardia in a dehydrated client. The client is already experiencing hypotension with position changes, indicating unstable hemodynamics. Administering this medication could worsen perfusion and delay recovery. D. Spironolactone should be withheld because it is a potassium-sparing diuretic and can worsen fluid loss and hypotension in a dehydrated client. In heat exhaustion, the priority is volume replacement, not diuresis. Continuing this medication could further reduce circulating volume and delay stabilization.