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:
High lipase is not a typical laboratory finding related to overusing prescribed diuretics and a sodium level of 127 mEq/L. Lipase is an enzyme involved in lipid digestion and is more relevant in assessing pancreatic function.
Choice B rationale:
High creatine kinase-MB (CK-MB) is not associated with overusing prescribed diuretics or hyponatremia (low sodium level). CK-MB is a specific marker for myocardial damage and is usually elevated in conditions like myocardial infarction.
Choice C rationale:
Low hemoglobin is not directly related to overusing prescribed diuretics and a sodium level of 127 mEq/L. Low hemoglobin may indicate anemia or other hematological issues but this is not a typical finding in this scenario.
Choice D rationale:
The correct answer is low urine specific gravity. Overusing diuretics can lead to excessive urination, causing the urine to become more dilute with lower specific gravity. A low urine specific gravity indicates decreased urine concentration and can be a sign of fluid and electrolyte imbalances, including hyponatremia.

Choice A rationale:
A warm left leg is a normal finding and does not require immediate intervention. Warmth indicates adequate circulation to the limb.
Choice B rationale:
A pedal pulse strength of 2 in the left leg indicates diminished pulse but does not require immediate intervention. The nurse should continue to monitor the pulse and report any significant changes to the healthcare provider.
Choice C rationale:
The client's report of pain in the foot of the left leg is an expected finding due to the fractured left femur. Pain is a subjective symptom, and the nurse should address the client's pain appropriately but not intervene immediately based on this finding.
Choice D rationale:
This is the correct choice. A capillary refill time of 3 seconds in the left foot suggests impaired circulation, which could be indicative of compartment syndrome or other circulation-related issues. The nurse should intervene immediately by notifying the healthcare provider to prevent further complications.