For a client with renal impairment needing a diuretic, what nursing intervention is crucial if potassium-sparing diuretics are used?

In the case of a client with renal impairment who is prescribed potassium-sparing diuretics, monitoring serum electrolytes, creatinine, and blood urea nitrogen (BUN) is a critical nursing intervention. Potassium-sparing diuretics, such as spironolactone, can lead to increased potassium levels in the blood (hyperkalemia) because they work by blocking aldosterone, which normally promotes potassium excretion. In patients with renal impairment, the kidneys may struggle to excrete excess potassium, further raising the risk of hyperkalemia.

Regularly checking serum electrolytes allows nurses to identify hyperkalemia early, which can prevent serious complications such as cardiac arrhythmias. Monitoring creatinine and BUN provides insight into renal function, helping to assess whether the kidneys are adequately clearing these waste products. This information is vital for adjusting medication dosing, ensuring the client's safety, and improving their overall management.

The other options, while relevant in certain contexts, do not address the immediate and critical need for electrolyte balance in clients taking potassium-sparing diuretics, especially those with compromised kidney function.