A patient's arterial blood gas (ABG) results show a pH of 7.35, PaCO2 of 40 mmHg, and HCO3- of 21 mEq/L. What type of acid-base imbalance is present and how would you classify it?

A. Notify the rapid response team due to the client’s clinical signs of a tension pneumothorax: The client presents with acute right-sided chest pain, dyspnea, hypotension, unilateral decreased breath sounds, hyperresonance, and agitation—classic signs of a tension pneumothorax, a life-threatening emergency requiring immediate intervention. Rapid response activation ensures rapid access to advanced airway and chest decompression support.
B. Reassure the client and administer prescribed analgesics for pain relief: The pain is a symptom of a serious underlying condition—possibly a collapsed lung. Administering pain medication could delay life-saving intervention.
C. Encourage the client to take deep breaths and use incentive spirometry: This intervention is appropriate for postoperative atelectasis, but it is contraindicated in tension pneumothorax. Increasing intrathoracic pressure through deep breaths may worsen the pneumothorax.
D. Elevate the head of the bed and increase oxygen to 4 L/min via nasal cannula: While increasing oxygen and elevating the head can help improve oxygenation, they do not treat the underlying cause. These supportive measures may be used after emergency intervention has been initiated.
E. Document the findings and re-evaluate in 15 minutes: Delaying intervention in this situation is unsafe. A tension pneumothorax can rapidly lead to cardiovascular collapse, so waiting even a few minutes may result in deterioration or death.

A. "Clients with hypoglycemia cannot participate in religious/cultural fasting.": While fasting can increase the risk of hypoglycemia in clients with type 1 diabetes, it is not absolutely prohibited. With close monitoring and adjustments to insulin and diet, some clients may safely observe fasting.
B. “Keeping supplies on hand to treat hypoglycemic episodes is important.": This is appropriate advice, as clients with type 1 diabetes are at risk for sudden drops in blood glucose. Readily available glucose tablets, juice, or snacks can help promptly correct hypoglycemia.
C. "Clients will usually have obvious manifestations of hypoglycemia.": Some individuals, especially those with long-standing diabetes, may experience hypoglycemia unawareness. They may not have typical warning signs, making early detection more difficult.
D. "Increasing exercise can help with hypoglycemia.”: Exercise generally lowers blood glucose levels and can actually trigger hypoglycemia if not planned with appropriate insulin or carbohydrate adjustments. It does not help treat or prevent hypoglycemia on its own.