A nurse is teaching a client about the sleep-wake cycle. The nurse should include that which of the following factors can interfere with the sleep-wake cycle? (Select All that Apply)

A) Halitosis: Halitosis refers to bad breath, which may or may not be related to bruxism. While teeth grinding can contribute to dental issues that may lead to halitosis, it is not the primary disorder associated with teeth grinding.
B) Sordes: Sordes refers to the accumulation of foul-smelling crusts or deposits around the teeth and gums, typically seen in individuals with poor oral hygiene or compromised oral health. It is not directly related to teeth grinding.
C) Bruxism: Bruxism refers to the habit of grinding or clenching the teeth, especially during sleep. It can lead to dental problems, jaw pain, headaches, and other issues related to the temporomandibular joint (TMJ). Referring the client to a dentist for evaluation and management of bruxism is appropriate to address the underlying dental concerns associated with teeth grinding.
D) Xerostomia: Xerostomia, also known as dry mouth, is a condition characterized by reduced saliva production. While xerostomia may exacerbate dental problems and contribute to oral discomfort, it is not specifically associated with teeth grinding.

A. Hyponatremia: Hyponatremia is characterized by low sodium levels in the blood and can lead to symptoms such as weakness, confusion, and seizures. While hyponatremia can contribute to fluid imbalance, the client's presentation with shortness of breath, lower extremity swelling, crackles in the lungs, and elevated blood pressure is more indicative of fluid volume excess rather than hyponatremia.

B. Hypervolemia: Hypervolemia, or fluid volume excess, occurs when there is an abnormal increase in the extracellular fluid volume. This can lead to symptoms such as shortness of breath, crackles in the lungs (indicative of pulmonary edema), peripheral edema, and elevated blood pressure. Given the client's reported symptoms and assessment findings, hypervolemia is the most likely diagnosis.

C. Hypovolemia: Hypovolemia, or fluid volume deficit, occurs when there is a decrease in the extracellular fluid volume. This condition is characterized by symptoms such as thirst, dry mucous membranes, decreased urine output, and hypotension. The client in this scenario presents with signs and symptoms consistent with fluid volume excess rather than hypovolemia.

D. Hyperkalemia: Hyperkalemia is characterized by elevated potassium levels in the blood and can lead to symptoms such as muscle weakness, cardiac dysrhythmias, and nausea. While hyperkalemia can occur in clients with end-stage kidney disease, the client's reported symptoms and assessment findings are more suggestive of fluid volume excess rather than hyperkalemia.