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:
(Fluticasone) Fluticasone is a corticosteroid inhaler used for the long-term management of asthma symptoms and prevention of asthma attacks. It is not suitable for treating acute asthma

attacks. Therefore, this is not the correct choice for medications to treat an acute asthma attack.
Choice B rationale:
(Albuterol) Albuterol is a short-acting beta-agonist bronchodilator and the preferred medication for relieving acute asthma symptoms and treating asthma attacks. It works by quickly relaxing the airway muscles, making it easier to breathe during an asthma attack. Therefore, this is the correct choice for medications to treat an acute asthma attack.
Choice C rationale:
(Salmeterol) Salmeterol is a long-acting beta-agonist bronchodilator used for the prevention of asthma symptoms but should not be used for treating acute asthma attacks. It has a slower onset of action compared to short-acting beta-agonists like albuterol. Therefore, this is not the correct choice for medications to treat an acute asthma attack.
Choice D rationale:
(Beclomethasone) Beclomethasone is a corticosteroid inhaler used for long-term asthma management and prevention of asthma symptoms but is not appropriate for treating acute asthma attacks. Therefore, this is not the correct choice for medications to treat an acute asthma attack.

Choice A rationale:
Assessing the need for oral suction every 4 hours is essential in maintaining airway patency and preventing complications associated with excessive secretions. This is an appropriate action and does not require clarification.
Choice B rationale:
Checking the ventilator settings every 12 hours is necessary to ensure that the mechanical ventilation is providing adequate support for the client's respiratory needs. This prescription is appropriate and does not need clarification.
Choice C rationale:
Keeping the head of the client's bed elevated at 30° is important in preventing aspiration and ventilator-associated pneumonia. This position helps promote optimal lung expansion and improves oxygenation in ventilated clients.
Choice D rationale:
Performing oral hygiene using an alcohol-based oral rinse is not recommended for clients receiving mechanical ventilation. Alcohol-based products can be harmful if aspirated and may disrupt the normal oral flora, leading to complications. The nurse should use a non-alcohol-based oral rinse or foam swabs instead.