A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate (TURP). The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?

Choice A reason:
This choice suggests a pH of 7.50, which is indicative of alkalosis, and not typically expected in a client with chronic kidney disease (CKD). CKD often leads to metabolic acidosis due to the accumulation of acids in the body as the kidneys fail to excrete them. The HCO₃⁻ level of 20 mEq/L is slightly lower than the normal range (22-26 mEq/L), and the PaCO₂ of 32 mm Hg is within the normal range (35-45 mm Hg), but these values do not align with the expected acidosis associated with CKD.

Choice B reason:
This set of values is consistent with metabolic acidosis, which is commonly seen in clients with CKD. A pH of 7.25 indicates acidemia, and an HCO₃⁻ level of 19 mEq/L is below the normal range, suggesting a primary metabolic acidosis. The PaCO₂ of 30 mm Hg is at the lower end of the normal range, which may indicate a compensatory respiratory response to the metabolic acidosis.

Choice C reason:
A pH of 7.30, while on the lower side, is not as acidic as one would expect in a client with CKD. The HCO₃⁻ level of 26 mEq/L is within the normal range, and a PaCO₂ of 50 mm Hg suggests respiratory acidosis, which is not the primary disorder in CKD.

Choice D reason:
This choice indicates a pH of 7.55, which is too alkaline and not characteristic of CKD, where metabolic acidosis is the expected finding. An HCO₃⁻ level of 30 mEq/L is higher than the normal range, suggesting metabolic alkalosis. The PaCO₂ of 31 mm Hg is slightly below the normal range, possibly indicating a compensatory response, but it does not align with the metabolic acidosis typically seen in CKD.

Choice A reason:
Bradycardia, or a heart rate that is slower than normal, is not a common finding in anemia. Anemia typically results in a compensatory increase in heart rate, known as tachycardia, to maintain adequate oxygen delivery to tissues.

Choice B reason:
Diarrhea is not a direct symptom of anemia. While it can be a postoperative complication due to various reasons, such as medication side effects or infections, it is not a symptom associated with anemia resulting from excess blood loss.

Choice C reason:
Fatigue is a hallmark symptom of anemia, regardless of the cause. When anemia is due to excess blood loss, the body's oxygen-carrying capacity is diminished due to the reduced number of red blood cells. This leads to fatigue, as tissues and organs receive less oxygen than is needed for optimal function.

Choice D reason:
Hypertension is not typically associated with anemia. In fact, anemia can sometimes lead to hypotension, or low blood pressure, because of the reduced volume of red blood cells in the circulatory system.