A client on spironolactone (Aldactone) requires close monitoring for which condition?

• A. Hypokalemia
• B. Hypoglycemia
• C. Hypermagnesemia
• D. Hyperkalemia

Answer: (D)

Spironolactone is a potassium-sparing diuretic that blocks aldosterone, causing the body to retain potassium. Because of this mechanism, the primary risk to monitor is hyperkalemia. Check serum potassium and kidney function regularly, and watch for signs of high potassium such as muscle weakness, fatigue, palpitations, or arrhythmias. Be cautious with other meds that raise potassium (like ACE inhibitors, ARBs, or potassium supplements) and with potassium-rich salt substitutes. Hypokalemia, hypermagnesemia, or hypoglycemia are not typical concerns with this drug.