A nurse is caring for a client who is at risk for respiratory alkalosis. Which of the following alterations should the nurse identify as an increased risk for this condition?

A. Born with a high birth weight: High birth weight is generally not considered a risk factor for hearing loss. In fact, low birth weight, prematurity, or complications during birth are more often associated with an increased risk of hearing issues.

B. Frequent exposure to low-volume noise: Frequent exposure to low-volume noise is not typically a risk factor for hearing loss. However, exposure to loud noises (high volume) over time is a significant risk factor for hearing damage and loss.

C. Use of a loop diuretic: The use of loop diuretics, such as furosemide, is associated with an increased risk of ototoxicity, which can lead to hearing loss. This is a known risk for people taking these medications, especially in high doses or with prolonged use.

D. Chronic infections of the middle ear: Chronic ear infections can lead to hearing loss by damaging the structures of the middle ear or causing scarring. Recurrent middle ear infections, or otitis media, increase the risk of long-term hearing impairment.

E. Perforation of the eardrum: A perforated eardrum can lead to hearing loss, particularly if it affects the middle ear's ability to transmit sound properly. It can also make the ear more susceptible to infections, which could further contribute to hearing loss.

A. Rejection can occur at any time. Hyperacute rejection happens within minutes to hours, and acute rejection typically occurs within days to months. Life-long vigilance is required.

B. Daily weight monitoring is a critical component of post-transplant care. Rapid weight gain is one of the earliest and most objective indicators of fluid retention, which can signal that the new kidney is not filtering effectively or that the body is beginning to reject the organ.

C. In a successful living-donor transplant, urine production usually begins immediately. A lack of urine (oliguria or anuria) in the first 12 hours is a medical emergency that may indicate a blood clot or technical failure.

D. A fever is never expected after a transplant. Because the patient is on immunosuppressants, even a low-grade fever can be the only sign of a serious infection or an early sign of organ rejection.