Which drug can help prevent metabolic alkalosis or hypokalemia in a client with cirrhosis receiving diuretic therapy?

Spironolactone is a potassium-sparing diuretic that plays a vital role in preventing metabolic alkalosis and hypokalemia, particularly in patients with cirrhosis undergoing diuretic therapy. In the context of cirrhosis, patients are often at risk for fluid retention, and diuretics are essential for managing this condition. However, many loop diuretics, such as furosemide and bumetanide, can lead to potassium loss and may contribute to the development of metabolic alkalosis.

Spironolactone works by antagonizing aldosterone, a hormone that prompts the kidneys to retain sodium and water, leading to the excretion of potassium. By blocking this action, spironolactone allows sodium and water excretion while retaining potassium, making it particularly beneficial for cirrhotic patients. This balance prevents the drop in potassium levels, thus minimizing the risk of hypokalemia. Additionally, it helps to prevent the alkalosis that can result from excessive loss of hydrogen ions and potassium.

In contrast, diuretics like furosemide and bumetanide do not provide this potassium-sparing effect, which can lead to significant electrolyte imbalances, particularly in patients with liver disease. Therefore,