A nurse is assisting with a presentation about caring for clients who are receiving diuretic therapy. The nurse should explain that which of the following medications can put clients at risk for hyperkalemia?

(A) Bradycardia: Bradycardia, or a slower than normal heart rate, is not typically associated with metabolic acidosis. Metabolic acidosis often leads to an increased heart rate (tachycardia) as the body tries to compensate for the acid-base imbalance.

(B) Hyperventilation: This is the most appropriate answer. Hyperventilation is a common response to metabolic acidosis. The body attempts to compensate for the high acid levels by increasing the rate and depth of breathing to expel more carbon dioxide (which is acidic) and raise the blood pH.

(C) Increased blood pressure: Metabolic acidosis does not typically cause an increase in blood pressure. In fact, severe acidosis can lead to vasodilation and a decrease in blood pressure.

(D) Cool, clammy skin: While cool, clammy skin can be a sign of shock or other serious conditions, it is not a typical manifestation of metabolic acidosis. However, in severe cases, metabolic acidosis can lead to shock, which might present with cool, clammy skin.

(A) Increase the heat in the client’s room: Increasing the heat in the client’s room is not typically recommended for a client experiencing dyspnea. Heat can sometimes make breathing more difficult, and it does not address the underlying cause of the dyspnea.

(B) Perform nasotracheal suctioning for the client: Nasotracheal suctioning can be used to clear the airway in certain situations, but it is not typically the first-line treatment for dyspnea in a client at the end of life. It can be uncomfortable and distressing for the client.

(C) Place the head of the client’s bed flat: Placing the head of the bed flat can actually make breathing more difficult for a client experiencing dyspnea. It is generally more helpful to elevate the head of the bed to facilitate easier breathing.

(D) Administer an opioid narcotic to the client: This is the most appropriate answer. Opioid narcotics can help to relieve dyspnea in clients at the end of life by reducing anxiety, decreasing the sensation of breathlessness, and improving the client’s overall comfort level. The use of opioids in this context should be carefully monitored to manage potential side effects.