The nurse is providing care for several clients at risk for acid-base imbalance. Which client has the greatest risk for respiratory acidosis?

A 58-year-old client who uses antacids every day

A 48-year-old client with an anxiety disorder

A 68-year-old client with chronic lung disease

A 28-year-old client with salicylate intoxication

Answer and Explanation

The Correct Answer is C

A. A 58-year-old client who uses antacids every day: Antacids primarily affect gastric acid levels and are not typically associated with respiratory acidosis. They might affect metabolic balance but not respiratory acidosis.
B. A 48-year-old client with an anxiety disorder: Anxiety disorders are more commonly associated with respiratory alkalosis due to hyperventilation, not respiratory acidosis.
C. A 68-year-old client with chronic lung disease: This is the correct choice because chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), often impair CO2 elimination, leading to respiratory acidosis due to CO2 retention.
D. A 28-year-old client with salicylate intoxication: Salicylate intoxication is often associated with metabolic acidosis, and initially, it can cause respiratory alkalosis due to hyperventilation, rather than respiratory acidosis.

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Correct Answer is C

Explanation

A. Abdomen soft, surgical dressing has scant amount of old drainage: A soft abdomen and minimal old drainage from the surgical dressing are expected findings postoperatively. They do not indicate an immediate concern that requires prompt action.
B. Client ambulating with minimal assistance, complaints of occasional nausea: Ambulation and occasional nausea are common and generally expected postoperatively. These findings do not require urgent collaboration with the healthcare provider.
C. Crackles bilaterally in bases of lungs, has incisional pain: Crackles in the lungs can indicate fluid accumulation or atelectasis, which may lead to pneumonia or other respiratory complications. This finding, especially combined with recent surgery, requires prompt evaluation and intervention.
D. Temperature 99.4°F (37.4°C), pulse 100 bpm, bowel sounds present: A slightly elevated temperature and increased pulse are common after surgery. The presence of bowel sounds is a positive sign indicating the return of gastrointestinal function. These findings are not immediately concerning.

A. Administer 10% sodium chloride via rapid infusion B. Administer intranasal antidiuretic hormone C. Encourage oral fluid intake D. Place the client on seizure precautions

Correct Answer is D

Explanation

A. Administer 10% sodium chloride via rapid infusion: Rapid infusion of high concentrations of sodium chloride can be dangerous and is not the standard treatment for severe hyponatremia.
B. Administer intranasal antidiuretic hormone: This would not be appropriate for correcting severe hyponatremia and could potentially worsen the condition.
C. Encourage oral fluid intake: For severe hyponatremia, oral fluid intake might not be sufficient and could exacerbate the condition if there is fluid overload.
D. Place the client on seizure precautions: This is the correct choice. Severe hyponatremia (sodium < 120 mEq/L) can lead to neurological symptoms and seizures, so implementing seizure precautions is crucial for safety.

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The nurse is providing care for several clients at risk for acid-base imbalance. Which client has the greatest risk for respiratory acidosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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