A nurse is collecting data from a client prior to administering atenolol.
For which of the following findings should the nurse withhold the medication?

Choice A rationale:

Metabolic alkalosis Metabolic alkalosis is characterized by an elevated pH (above the normal range of 7.35-7.45) and an increased bicarbonate (HCO3) level (above the normal range of 22-28 mEq/L). In this case, the client's pH of 7.6 and HCO3 level of 32 mEq/L indicate a primary metabolic alkalosis. It can be caused by excessive bicarbonate intake, loss of acid (as in vomiting or excessive diuretic use), or other factors that result in an excess of bicarbonate in the body. The PaCO2 level is within the normal range (35-45 mm Hg), which is consistent with compensatory hypoventilation seen in metabolic alkalosis.

Choice B rationale:

Metabolic acidosis Metabolic acidosis is characterized by a decreased pH and bicarbonate level. The client's ABG results do not align with metabolic acidosis. In this case, the pH is elevated, and the bicarbonate level is above the normal range.

Choice C rationale:

Respiratory alkalosis Respiratory alkalosis is characterized by an elevated pH and decreased PaCO2. The client's ABG results show a normal PaCO2 of 40 mm Hg, which does not align with respiratory alkalosis. In respiratory alkalosis, you would typically see a lower PaCO2.

Choice D rationale:

Respiratory acidosis Respiratory acidosis is characterized by a decreased pH and elevated PaCO2. The client's ABG results do not align with respiratory acidosis. In this case, the PaCO2 is within the normal range, and the pH is elevated, which is not indicative of respiratory acidosis.

Choice A rationale:

Crackles in lung bases Crackles in the lung bases are often indicative of fluid accumulation in the lungs, which can occur in conditions like heart failure. These crackles are discontinuous and sound like "fine rales.”. They can be heard during inspiration and expiration.

Choice B rationale:

Periorbital edema Periorbital edema, or swelling around the eyes, can be a sign of fluid volume overload, especially in the context of an older adult receiving IV therapy. It suggests that excess fluid is accumulating in the body.

Choice D rationale:

Bounding radial pulse A bounding radial pulse is a sign of increased stroke volume and can occur when the heart is working harder to pump the increased blood volume associated with fluid overload.

Choice C rationale:

Swelling at the IV site Swelling at the IV site can be a local reaction and may not necessarily indicate fluid volume overload unless it is associated with other systemic signs.

Choice E rationale:

Flat neck veins when supine Flat neck veins when the client is supine are not typically associated with fluid volume overload. In fact, flat neck veins are more characteristic of hypovolemia. Now, let's address the final question.