A nurse is attending to a client with a peripheral vascular access device who is experiencing pain, redness, and swelling at the site. What action should the nurse take to alleviate the pain after removing the device?

Choice A rationale:
Metabolic alkalosis is a condition characterized by an increase in the pH of the blood due to an excess of bicarbonate (HCO3-) in the body. It is not typically caused by severe diarrhea. In fact, diarrhea can often lead to a loss of bicarbonate, which can contribute to metabolic acidosis.
Causes of metabolic alkalosis include: excessive vomiting, use of diuretics, and excessive intake of alkali such as antacids. Clinical manifestations of metabolic alkalosis include: muscle twitching, paresthesias, seizures, confusion, and lethargy.
Choice B rationale:
Respiratory alkalosis is a condition characterized by a decrease in the partial pressure of carbon dioxide (PaCO2) in the blood, leading to an increase in blood pH. It is caused by hyperventilation, which removes excess CO2 from the body. Severe diarrhea does not typically cause hyperventilation.
Causes of respiratory alkalosis include: anxiety, hyperventilation syndrome, high altitude sickness, and pulmonary embolism. Clinical manifestations of respiratory alkalosis include: lightheadedness, dizziness, paresthesias, palpitations, and tetany.
Choice C rationale:
Respiratory acidosis is a condition characterized by an increase in the partial pressure of carbon dioxide (PaCO2) in the blood, leading to a decrease in blood pH. It is caused by hypoventilation, which prevents the body from removing enough CO2. Severe diarrhea does not typically cause hypoventilation.
Causes of respiratory acidosis include: chronic obstructive pulmonary disease (COPD), pneumonia, asthma, and neuromuscular disorders.
Clinical manifestations of respiratory acidosis include: headache, confusion, somnolence, and coma.
Choice D rationale:
Metabolic acidosis is a condition characterized by a decrease in the pH of the blood due to an excess of acid in the body or a loss of bicarbonate. Severe diarrhea can lead to metabolic acidosis through several mechanisms:
Loss of bicarbonate in the stool: Diarrhea often contains a significant amount of bicarbonate, which can be lost from the body in large amounts during severe diarrheal episodes. This loss of bicarbonate can lead to a decrease in the blood's pH, resulting in metabolic acidosis.
Dehydration: Severe diarrhea can also lead to dehydration, which can concentrate acids in the blood and contribute to metabolic acidosis.
Lactic acidosis: In some cases, severe diarrhea can also cause lactic acidosis, a type of metabolic acidosis that occurs when there is a buildup of lactic acid in the body. This can happen due to impaired circulation or tissue hypoxia, which can occur as a complication of severe diarrhea.

Choice A rationale:
Wearing a respirator when handling urine output is not routinely recommended for MRSA infections. While airborne transmission of MRSA is possible, it is primarily spread through direct contact with infected skin or surfaces. Respirators are typically reserved for situations where there is a high risk of aerosolization, such as during certain medical procedures.
The use of a respirator can be cumbersome and uncomfortable, and it may not provide significant additional protection in this context.

It's important to prioritize hand hygiene and contact precautions over respirator use for routine care of patients with MRSA infections.
Choice B rationale:
Limiting visitors strictly to immediate family members only is not necessary for MRSA infection control. Visitors can be educated on proper hand hygiene and contact precautions to minimize the risk of transmission.
Restricting visitors can have negative psychosocial impacts on the patient, such as isolation and decreased social support. It's important to balance infection control measures with the patient's overall well-being.
Choice C rationale:
Washing hands only after removing gloves post-care is inadequate for MRSA infection control. Hands should be washed thoroughly with soap and water or an alcohol-based hand sanitizer:
Before and after entering the patient's room
Before and after any contact with the patient or their surroundings After removing gloves
After using the toilet Before eating or drinking.

Choice D rationale:
Vancomycin is an antibiotic that is effective against MRSA infections. It is often the first-line treatment for these infections.
Preparing to administer vancomycin as prescribed by the healthcare provider is the most appropriate action to take to address the patient's MRSA infection.
Prompt initiation of appropriate antibiotic therapy is essential to controlling the infection and preventing complications.