A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

Choice A: A cervical spinal cord injury can impair the function of cranial nerves, leading to a weakened gag reflex and an increased risk of aspiration.

Choice B:Patients with spinal cord injuries are more likely to experience poikilothermia (difficulty regulating body temperature), but this often results in hypothermia, not hyperthermia, due to the loss of autonomic temperature control.

Choice C:Spinal shock, which often follows a spinal cord injury, can cause decreased or absent bowel sounds due to a temporary loss of autonomic function and decreased peristalsis.

Choice D:Depending on the level and severity of the injury, paralysis can occur, affecting motor function below the injury site. A cervical spinal cord injury may lead to quadriplegia (tetraplegia).

Choice E:Clients with spinal cord injuries are more likely to experience urinary retention, rather than polyuria, due to loss of bladder control and autonomic dysfunction. A foley catheter may be needed initially, followed by intermittent catheterization.

Choice F:Neurogenic shock, a potential complication of cervical spinal cord injuries, can cause hypotension due to the loss of sympathetic nervous system control over blood vessel tone, leading to vasodilation and bradycardia.

Choice a) is incorrect because calcium levels are not directly affected by hemodialysis. Calcium is a mineral that is important for bone health, blood clotting, and muscle contraction. Hemodialysis does not remove calcium from the blood, but it may cause low calcium levels if the dialysate fluid has a lower concentration of calcium than the blood.

Choice b) is correct because potassium levels are decreased by hemodialysis. Potassium is an electrolyte that is essential for nerve and muscle function, especially the heart. Hemodialysis removes excess potassium from the blood, which can build up in people with kidney failure and cause irregular heartbeats, muscle weakness, or even cardiac arrest.

Choice c) is incorrect because protein levels are not decreased by hemodialysis. Protein is a macromolecule that is composed of amino acids and performs various functions in the body, such as building and repairing tissues, transporting substances, and regulating processes. Hemodialysis does not remove protein from the blood, but it may cause low protein levels if the client has a poor diet or loses protein through other means, such as urine or wounds.

Choice d) is incorrect because RBC count is not decreased by hemodialysis. RBCs are red blood cells that carry oxygen throughout the body. Hemodialysis does not remove RBCs from the blood, but it may cause low RBC count if the client has anemia, which is a common complication of kidney failure. Anemia can be caused by reduced production of erythropoietin (a hormone that stimulates RBC production), iron deficiency, or blood loss.