A nurse is assessing a client who is in the first stage of labor.

Which finding should the nurse report to the provider immediately?

Keep the drainage system below the level of the client's chest.

Rationale: Keeping the drainage system below the level of the client's chest prevents backflow of fluid into the pleural space and maintains negative pressure in the system.

Incorrect options:

A) Clamp the chest tube periodically to check for air leaks. - This is an incorrect action, as clamping the chest tube can cause a tension pneumothorax or impair lung re-expansion. The nurse should only clamp the chest tube briefly when changing the drainage system or when ordered by the provider.

C) Empty the drainage chamber when it is half full. - This is an incorrect action, as emptying the drainage chamber can disrupt the water seal and allow air to enter the pleural space. The nurse should only empty the drainage chamber when it is full or when changing the system.

D) Add sterile water to the suction control chamber as needed. - This is an incorrect action, as adding sterile water to the suction control chamber can increase or decrease the amount of suction applied to the chest tube, depending on whether water is added or removed. The nurse should only add sterile water to the water seal chamber if it falls below the 2 cm mark.

Serum potassium level of 6.5 mEq/L

Rationale: A serum potassium level of 6.5 mEq/L indicates hyperkalemia, which is a potential complication of DKA due to insulin deficiency, acidosis, and dehydration. Hyperkalemia can cause cardiac dysrhythmias, muscle weakness, and paresthesia.

Incorrect options:

A) Blood glucose level of 350 mg/dL - This is an expected finding for a client who has DKA, as insulin deficiency leads to hyperglycemia and glycosuria. The goal of treatment for DKA is to lower blood glucose levels gradually to prevent cerebral edema.

C) Arterial blood pH of 7.25 - This is an expected finding for a client who has DKA, as insulin deficiency leads to increased breakdown of fatty acids and production of ketones, resulting in metabolic acidosis. The normal range for arterial blood pH is 7.35 to 7.45.

D) Serum bicarbonate level of 18 mEq/L - This is an expected finding for a client who has DKA, as metabolic acidosis causes a decrease in serum bicarbonate levels due to buffering mechanisms. The normal range for serum bicarbonate levels is 22 to 26 mEq/L.