Which finding in a client taking hydrochlorothiazide (Microzide) for hypertension should concern the nurse most?

• A. Feelings of sadness.
• B. Increased urination.
• C. Persistent, dry cough.
• D. Dizziness when standing.

Answer: (D)

The most concerning finding in a client taking hydrochlorothiazide (Microzide) for hypertension is dizziness when standing, which indicates a potential issue known as orthostatic hypotension. Hydrochlorothiazide is a diuretic that promotes the excretion of sodium and water from the body, which can lead to dehydration and electrolyte imbalances. As a result, when a patient stands up, blood pressure may drop, leading to dizziness or lightheadedness. This can increase the risk of falls and injury, making it essential for the nurse to assess the client further and intervene if necessary. Monitoring for signs of dehydration, evaluating blood pressure regularly, and educating the client about changing positions slowly are crucial in managing this effect.

Increased urination is a common and expected side effect of diuretics, as they are meant to increase urine output to help lower blood pressure. Feelings of sadness could be related to various factors, including situational depression, and while they warrant attention, they are not an immediate concern related to the use of hydrochlorothiazide. A persistent, dry cough is more indicative of an adverse reaction related to medications like ACE inhibitors rather than thiazide diuretics, thus making it less relevant in this scenario.