The LPN is caring for a client that was recently started on furosemide for dependent edema caused by right sided heart failure. Which nursing actions are appropriate to add to the plan of care for the patient?

A. Assess the patient's appetite and thirst: While loop diuretics can cause dehydration, appetite monitoring is not the primary nursing priority for managing loop diuretic therapy. Thirst may occur, but it is a subjective symptom rather than a critical objective indicator of electrolyte imbalance. Clinical focus remains on metabolic and hemodynamic stability. B. Monitor magnesium levels, as ordered: Loop diuretics inhibit the reabsorption of cations in the thick ascending limb of the loop of Henle. This mechanism leads to increased urinary excretion of magnesium alongside water and sodium. Hypomagnesemia can predispose the client to cardiac arrhythmias and muscle tetany. C. Assess the client for gastric distress including nausea, vomiting and diarrhea: These gastrointestinal symptoms are not the most common or significant adverse effects of furosemide administration. While they can occur with many medications, they do not reflect the primary pharmacological risks associated with diuretic-induced fluid shifts. Monitoring should prioritize renal function and electrolyte concentrations. D. Monitor the client's potassium levels as ordered: Furosemide promotes significant potassium wasting by increasing delivery of solutes to the distal tubule. Hypokalemia is a frequent and dangerous complication that can lead to life-threatening cardiac conduction disturbances. Frequent serum monitoring is essential to ensure the safety of the heart failure patient.