Pharmacology 7th Edition by Henry Hitner,Barbara Nagle

Exercise 24

Mrs. McNally is a 65-year-old female who presents at the clinic where you're working with complaints of increased shortness of breath and swelling of her feet. Her past medical history includes a diagnosis of hypertension and moderate degree of renal failure. Pertinent laboratory tests show a slightly decreased potassium level of 3.2 M/l (normal 3.5-5 M/l) and an increased serum creatinine of 2.1 mg/dl (normal 0.8-1.5 mg/dl). The physician's diagnosis is acute congestive heart failure. The physician's course of therapy includes doubling Mrs. McNally's dose of hydrochlorothiazide from 25 mg to 50 mg daily and prescribing digoxin 0.25 mg twice daily for 2 days and then 0.25 mg daily.
a. What is the most likely electrolyte disturbance that may occur in this patient
b. What does the increased level of serum creatinine suggest about this patient's renal function