A nurse is caring for a client who is experiencing anxiety as well as numbness and tingling of the lips and fingers. The client's ABGs are pH 7.48, PCO2 30 mm Hg, HCO3 24 mEq/L, PaO2 85 mm Hg. Which of the following acid-base imbalances should the nurse identify that the client is experiencing?

Choice A rationale:

A blood glucose level of 100 mg/dL is within the normal range, so there is no need to notify the provider of this finding.

Choice B rationale:

A client's temperature of 37.6°C (99.7°F) is slightly elevated but not considered a critical finding. It may be indicative of an infection or other mild inflammation, but it does not warrant immediate provider notification.

Choice C rationale:

A potassium level of 5.7 mEq/L is above the normal range (3.5-5.0 mEq/L). Hyperkalemia can lead to serious cardiac complications, such as arrhythmias, and requires immediate attention from the provider.

Choice D rationale:

Weight loss of 0.8 kg/day (1.8 lb/day) should be evaluated and monitored, but it is not an immediate concern that warrants urgent provider notification.

Answer: D. The nurse refers a client who has chronic obstructive pulmonary disease for palliative care services:

Rationale:

A) The nurse files an incident report regarding a medication error:

Filing an incident report about a medication error is an important action for ensuring safety and quality improvement within the healthcare setting. However, it is primarily a procedural and administrative task rather than an act of direct advocacy for an individual client's needs or rights.

B) The nurse provides wound care to a client at the time promised to the client:

Providing wound care as promised demonstrates reliability and adherence to care plans, which is essential for trust and effective nursing practice. While this action shows respect for the client's needs and preferences, it does not specifically address the broader role of advocacy, which often involves intervening on behalf of the client's best interests in more complex situations.

C) The nurse declines to inform a client's neighbor about the client's prognosis:

Maintaining client confidentiality by not sharing private information with unauthorized individuals is a fundamental aspect of ethical nursing practice. This action protects the client's privacy but is more about upholding legal and ethical standards than actively advocating for the client's overall well-being or specific needs.

D) The nurse refers a client who has chronic obstructive pulmonary disease for palliative care services:

Referring a client with chronic obstructive pulmonary disease (COPD) to palliative care services exemplifies client advocacy. This action recognizes the client's need for comprehensive support, focusing on improving quality of life, managing symptoms, and providing holistic care. It involves proactive steps to address the client's complex health needs, ensuring they receive appropriate and compassionate care beyond standard medical treatment.