A nurse is caring for a patient who has the following arterial blood values: pH 7.12, PaO 56 mm Hg, PaCO 65 mm Hg, and HCO - 22 mEq/L (22 mmol/L). Which clinical situation does the nurse correlate with these values?

A. Arrange for the patient to receive gamma globulin.

Gamma globulin is a blood product that contains antibodies and is sometimes used for post-exposure prophylaxis in certain situations, such as for individuals who are immunocompromised or pregnant and have been exposed to varicella (chickenpox) or measles. However, for a frail, older adult who had chickenpox as a child and has been exposed to varicella again, arranging for gamma globulin may not be necessary if the patient is already immune to chickenpox.

B. Assess frequently for herpes zoster.

Herpes zoster (shingles) is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. While exposure to varicella can increase the risk of developing shingles in individuals who are susceptible, frequent assessment for herpes zoster is not necessary in this case if the patient is known to have had chickenpox in the past.

C. Be aware of the patient's immunity to chickenpox.

This option is the correct choice. Since the patient had chickenpox as a child, they likely have immunity to chickenpox. Being aware of this immunity helps the nurse understand that the patient may not develop chickenpox again even after exposure to varicella.

D. Encourage the patient to have a pneumonia vaccine.

Encouraging the patient to have a pneumonia vaccine is unrelated to the immediate concern of exposure to varicella. While pneumonia vaccines are important for older adults, especially those who are frail, the priority in this scenario is to determine the patient's immunity to chickenpox due to prior infection.

A. Excessive scarring:

Excessive scarring is not an example of a first-degree burn. It typically occurs in more severe burns that affect deeper layers of the skin, such as second-degree or third-degree burns. Second-degree burns extend into the dermis, while third-degree burns damage all layers of the skin and can lead to significant scarring. First-degree burns, on the other hand, only affect the outer layer of the skin (epidermis) and usually do not result in excessive scarring.

B. Blistering from flames:

Blistering from flames is more characteristic of a second-degree burn rather than a first-degree burn. Second-degree burns involve damage to both the epidermis and part of the dermis, which can result in blister formation. These burns are often caused by direct contact with flames, hot liquids, or steam.

C. Blackened dead skin:

Blackened dead skin is indicative of a third-degree burn, which is the most severe type of burn. Third-degree burns damage all layers of the skin, including the epidermis, dermis, and sometimes underlying tissues. The skin may appear charred or blackened, and these burns often require medical intervention, such as skin grafting, due to the extent of tissue damage.

D. A sunburn:

A sunburn is an example of a first-degree burn. It occurs due to overexposure to ultraviolet (UV) radiation from the sun, leading to redness, pain, and mild swelling of the skin. First-degree burns affect only the outer layer of the skin (epidermis) and typically heal within a few days without significant scarring or blistering. Applying soothing lotions, staying hydrated, and avoiding further sun exposure can help manage sunburns.