A client with hypertension and type 2 diabetes has recently started taking chlorthalidone. Which report by the client is most concerning to the nurse?

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Thiazide diuretics (eg, hydrochlorothiazide, chlorthalidone) are prescribed to treat hypertension and edema. The major side effects of thiazide diuretics include: Hypokalemia - manifests as muscle cramps (Option C) Hyponatremia - manifests as altered mental status and seizures Hyperuricemia - may precipitate or worsen gout attacks Hyperglycemia - may require adjustment of diabetic medications Hypokalemia is the most serious side effect of thiazide diuretics as it can lead to life-threatening cardiac dysrhythmias. (Option A) Orthostatic hypotension may be a side effect of any diuretic. The nurse should teach the client to sit for a few minutes before standing and rise slowly. The nurse should also check that the client's blood pressure is not too low. (Option B) Mild to moderate hyperglycemia is common with thiazides and needs to be addressed. However, it is not life-threatening and therefore not a priority. (Option D) Most thiazide diuretics are sulfa derivatives and can therefore cause photosensitivity. The nurse should encourage the client to use sunscreen and wear protective clothing. Educational objective: The nurse should suspect hypokalemia in the presence of muscle cramps in a client taking diuretics. Hypokalemia can lead to dangerous ventricular dysrhythmias.

A Client with Hypertension and Type 2 Diabetes Has Recently