A nurse is reviewing the ABG values of a client. The client has a pH of 7.2, PaCO2 of 60 mm Hg, and HCO3 of 25 mEq/L. The nurse should identify that the client has which of the following acid-base imbalances?

Choice A rationale:

Preeclampsia is not a contraindication for the administration of misoprostol for induction of labor. Misoprostol is a prostaglandin E1 analog used for cervical ripening and induction of labor. It is not contraindicated in patients with preeclampsia. However, its use should be carefully monitored in patients with hypertensive disorders of pregnancy due to the potential impact on blood pressure.

Choice B rationale:

Transverse fetal lie is a contraindication for the administration of misoprostol for induction of labor. Misoprostol should not be used when the baby is in a transverse position because it can lead to complications during delivery. Induction methods should be chosen carefully based on the fetal presentation to ensure a safe delivery process.

Choice C rationale:

Intrauterine growth restriction (IUGR) is not a contraindication for the administration of misoprostol for induction of labor. IUGR refers to a condition where a fetus does not grow at the expected rate inside the uterus. While the cause of IUGR needs to be addressed, misoprostol itself is not contraindicated in these cases. However, the healthcare provider should assess the overall fetal well-being before deciding on the induction method.

Choice D rationale:

Postterm pregnancy is not a contraindication for the administration of misoprostol for induction of labor. In postterm pregnancies, where the pregnancy has extended beyond 42 weeks, healthcare providers may consider inducing labor to prevent complications associated with prolonged gestation. Misoprostol is one of the options for induction in postterm pregnancies, although the choice of induction method may vary based on various factors.

The correct answer is B, C, and E.

• A. Weight is not a correct choice because it is not a vital sign and it does not indicate an acute change in the client's condition.
• B. Neuro status is a correct choice because it reflects the client's level of consciousness, orientation, memory, and cognitive function. Any alteration in neuro status could indicate a serious problem such as infection, stroke, or medication toxicity.
• C. Auditory hallucinations are a correct choice because they are a symptom of psychosis and could indicate a relapse or worsening of the client's mental illness. Auditory hallucinations could also impair the client's ability to cope, communicate, and function effectively.
• D. Speech is not a correct choice because it is not a vital sign and it does not indicate an acute change in the client's condition. Speech could be affected by various factors such as mood, anxiety, or medication side effects.
• E. Restlessness is a correct choice because it is a sign of agitation, anxiety, or discomfort. Restlessness could also indicate an underlying physical or psychological problem such as pain, infection, or psychosis.