A client with Cushing's syndrome is receiving education about dietary changes from the nurse. Which statement by the patient demonstrates the need for further teaching?

A. Inform the primary care provider that the patient may have an infection:
Explanation: The presence of an elevated oral temperature and new onset of fine crackles on lung auscultation suggests a potential respiratory infection, which is a significant concern in a patient with sickle cell disease. Notifying the primary care provider allows for further evaluation and appropriate management of the infection.

B. Liaise with the respiratory therapist and consider high-flow oxygen:
Explanation: While oxygenation may be necessary, especially if the patient is experiencing respiratory distress, addressing the potential infection is the priority. Consulting with the respiratory therapist and considering high-flow oxygen can be part of the overall plan based on the primary care provider's recommendations.

C. Apply supplementary oxygen by nasal cannula:
Explanation: Providing oxygen support may be necessary, but it should be done in consultation with the primary care provider, who can guide the appropriate level of oxygen therapy based on the patient's condition.

D. Administer bronchodilators by nebulizer:
Explanation: Bronchodilators are typically used for conditions like asthma or COPD, and their use might not be the primary intervention in the context of a sickle cell crisis with signs of a potential respiratory infection. Addressing the infection takes precedence, and the primary care provider's input is essential in determining the appropriate course of action.

A. Asthma:
Explanation: Asthma is associated with respiratory alkalosis, not respiratory acidosis. In asthma, there is often hyperventilation leading to a decrease in carbon dioxide levels.

B. Hyperventilation:
Explanation: Correct. Hyperventilation can cause respiratory alkalosis, not respiratory acidosis. It leads to a decrease in carbon dioxide levels.

C. Chronic obstructive pulmonary disease (COPD):
Explanation: Correct. Conditions like COPD can lead to respiratory acidosis. In COPD, there is impaired ventilation, leading to an accumulation of carbon dioxide.

D. Renal insufficiency:
Explanation: Renal insufficiency is not a direct cause of respiratory acidosis. Respiratory acidosis is primarily related to respiratory system dysfunction.

E. Pneumonia:
Explanation: Correct. Pneumonia can cause respiratory acidosis. In pneumonia, there may be difficulty in eliminating carbon dioxide due to impaired gas exchange.