A client on torsemide reports cramping in the lower extremities. Which laboratory finding would you most likely expect?

A client on torsemide reports cramping in the lower extremities. Which laboratory finding would you most likely expect?

• A. Calcium level of 11 mg/dL
• B. Potassium level of 3.1 mEq/L
• C. Sodium level of 140 mEq/L
• D. pH level of 7.40

Answer: (B)

Loop diuretics like torsemide promote potassium loss in the distal nephron, which can lead to hypokalemia. Low potassium levels commonly cause muscle cramps, including in the legs, so a potassium of 3.1 mEq/L best explains the cramping. The other labs don’t align with the symptom: a calcium of 11 mg/dL suggests hypercalcemia, which isn’t a typical effect of loop diuretics and wouldn’t explain cramping in this context; a normal sodium of 140 mEq/L wouldn’t account for the symptoms; and a pH of 7.40 is normal, whereas diuretics can cause a contraction alkalosis that would shift pH, not leave it unchanged. The key link is the potassium loss leading to leg cramps.

Loop diuretics like torsemide promote potassium loss in the distal nephron, which can lead to hypokalemia. Low potassium levels commonly cause muscle cramps, including in the legs, so a potassium of 3.1 mEq/L best explains the cramping. The other labs don’t align with the symptom: a calcium of 11 mg/dL suggests hypercalcemia, which isn’t a typical effect of loop diuretics and wouldn’t explain cramping in this context; a normal sodium of 140 mEq/L wouldn’t account for the symptoms; and a pH of 7.40 is normal, whereas diuretics can cause a contraction alkalosis that would shift pH, not leave it unchanged. The key link is the potassium loss leading to leg cramps.