A nurse is caring for a client.

Exhibits

Which of the following actions should the nurse take? (Select all that apply.)

A. Increased arterial oxygen: Clients with COPD typically experience chronic hypoxemia due to alveolar destruction, airway inflammation, and mucus production, which impair gas exchange. Rather than increased oxygen levels, they often have a decreased PaO₂, requiring supplemental oxygen therapy. However, excessive oxygen administration can suppress their respiratory drive, worsening CO₂ retention.
B. Increased pH: COPD is associated with respiratory acidosis due to chronic CO₂ retention from inadequate alveolar ventilation. While the kidneys compensate by increasing bicarbonate retention, the pH usually remains low or near normal in chronic cases rather than becoming elevated. A higher pH would indicate alkalosis, which is not typical in COPD unless there is an additional metabolic disturbance.
C. Increased carbon dioxide: COPD causes airway obstruction and reduced alveolar ventilation, leading to CO₂ retention (hypercapnia). As CO₂ accumulates in the blood, it lowers the pH, resulting in respiratory acidosis. Chronic hypercapnia is a hallmark of advanced COPD, and in response, the kidneys retain bicarbonate to partially compensate, stabilizing the pH over time but leaving PaCO₂ elevated.
D. Decreased alveolar function: While COPD does lead to progressive alveolar damage and reduced gas exchange, this is a structural and functional change rather than a specific abnormality seen in arterial blood gases. The primary ABG finding in COPD is hypercapnia, which reflects inadequate ventilation and CO₂ retention rather than just decreased alveolar function alone.

A. Standard: While a standard resume format includes basic information about education and experience, it may not effectively address the nurse's multiple moves and varied positions, potentially raising concerns about stability and commitment.
B. Functional: This resume type is most appropriate for the nurse in this situation as it focuses on skills and experiences rather than a chronological work history. This format allows the nurse to highlight relevant skills gained in different positions without emphasizing the frequent changes in employment, which could be beneficial in presenting a cohesive professional narrative.
C. Sequence: This term is less commonly used in resume types and may not provide clarity in presenting qualifications or experiences.
D. Chronological: While this format lists experiences in reverse chronological order, it may draw attention to the frequent changes in positions and locations, which could raise red flags for potential employers regarding the nurse's commitment and stability in a job.