A nurse is reviewing the arterial blood gas values for a client. The nurse should recognize that the values indicate which of the following acid-base imbalances?

The values are:

• pH: 7.56
• PaCO2: 55 mmHg
• HCO3: 33 mEq/L

Normal ranges:

• pH: 7.35-7.45
• PaCO2: 35-45 mmHg
• HCO3: 22-28 mEq/L

Choice A Reason:

Losing weight is one of the most effective ways to reduce the severity of obstructive sleep apnea (OSA). Excess weight, especially around the neck, can increase the risk of airway obstruction during sleep. Studies have shown that losing even 5-10% of body weight can significantly improve OSA symptoms. Therefore, the statement about losing 50 pounds indicates a good understanding of how weight loss can help manage sleep apnea.

Choice B Reason:

Taking a sleeping pill at night is not recommended for individuals with obstructive sleep apnea. Many sleeping pills, especially those that are sedatives or muscle relaxants, can worsen sleep apnea by relaxing the muscles of the throat, leading to increased airway obstruction. Therefore, this statement does not indicate an understanding of the appropriate management of sleep apnea.

Choice C Reason:

Using a humidifier can help alleviate some symptoms associated with sleep apnea, such as dry mouth and nasal congestion, but it does not directly reduce the number of apneic episodes. While a humidifier can improve comfort, it is not a primary treatment for reducing apneic episodes in OSA patients.

Choice D Reason:

Sleeping on the back is generally not recommended for individuals with obstructive sleep apnea. This position can cause the tongue and soft tissues to collapse to the back of the throat, worsening airway obstruction. Side sleeping is usually recommended to help keep the airway open. Therefore, this statement does not indicate an understanding of the best sleep practices for managing sleep apnea.

Choice A Reason:

Keep the drainage system below the level of the client’s chest at all times is correct. This measure ensures that gravity assists in the drainage of air and fluid from the pleural space, preventing backflow into the chest cavity. Keeping the drainage system below chest level maintains the negative pressure needed for effective drainage.

Choice B Reason:

Clamp the chest tube prior to transferring the client to a wheelchair is incorrect. Clamping the chest tube can lead to a buildup of air or fluid in the pleural space, potentially causing a tension pneumothorax. The chest tube should remain unclamped to allow continuous drainage.

Choice C Reason:

Empty the collection chamber prior to transport is incorrect. While it is important to monitor and manage the drainage, emptying the collection chamber is not necessary before transport. The focus should be on maintaining the integrity and function of the drainage system.

Choice D Reason:

Disconnect the chest tube from the drainage system during transport is incorrect. Disconnecting the chest tube can lead to a loss of the negative pressure system, resulting in potential complications such as pneumothorax. The chest tube should remain connected to ensure continuous drainage and maintain the negative pressure.