The nurse is reading the results of an arterial blood gas showing pH 7.52, CO2 25, and HCO3- 24. The nurse interprets this as which of the following

A. The blockage is most likely in the right parietal region:
While a facial droop and weakness can be indicative of a stroke, the specific location of the blockage cannot be definitively determined based on the symptoms alone. A right-sided facial droop suggests that the lesion or event likely involves the left side of the brain, particularly the frontal or temporal regions, as these areas are typically associated with facial motor control. A parietal lesion would more commonly result in sensory deficits or spatial issues, not primarily facial droop. Therefore, this statement is not correct in this case.

B. This type of event can be one of the primary warning signs of a future stroke:
The client’s presentation of unilateral facial droop and weakness that resolves spontaneously within an hour is highly consistent with a transient ischemic attack (TIA). A TIA, often referred to as a "mini-stroke," is characterized by temporary neurological deficits that resolve without permanent damage. TIAs are considered warning signs of a potential future stroke, and the client should be evaluated promptly to address risk factors and prevent a more serious, permanent stroke.

C. The signs and symptoms are most consistent with an acute hemorrhagic stroke:
An acute hemorrhagic stroke typically presents with sudden and severe neurological deficits, such as a severe headache, vomiting, and loss of consciousness. Hemorrhagic strokes do not typically resolve spontaneously within an hour. The client's symptoms (unilateral facial droop and weakness that resolve within an hour) are more indicative of a TIA, not a hemorrhagic stroke. A hemorrhagic stroke would likely result in sustained deficits and a more urgent clinical presentation.

D. The signs and symptoms are most consistent with a focal awareness seizure:
Focal awareness seizures (previously known as simple partial seizures) generally involve abnormal electrical activity in a specific area of the brain, leading to symptoms such as motor twitches or sensory disturbances, but not typically a full facial droop or weakness. These seizures do not cause symptoms that resolve in such a short time, nor do they present with unilateral weakness in the manner described here. Therefore, this scenario is not consistent with a seizure disorder.

A) Nitrofurantoin (Macrobid): While nitrofurantoin is commonly prescribed for urinary tract infections (UTIs), it does not typically cause a red-orange discoloration of the urine. Nitrofurantoin may cause other side effects, such as gastrointestinal upset or pulmonary issues, but urine discoloration is not a common or expected side effect.

B) Sulfamethoxazole-trimethoprim (SMX TMP, Bactrim): Sulfamethoxazole-trimethoprim is another common medication for UTIs, but it does not cause urine to turn red-orange. Some individuals may experience allergic reactions, rash, or gastrointestinal side effects, but urine discoloration is not typically associated with this medication.

C) This is expected with a UTI not related to medications: While it’s true that UTIs can cause changes in urine color due to blood or infection, the red-orange discoloration specifically linked to a UTI is often caused by medications, not the infection itself. Therefore, this statement is not accurate in explaining the cause of the urine color change.

D) Phenazopyridine (Pyridium): This is the correct answer. Phenazopyridine is a medication commonly used to alleviate urinary tract pain and discomfort. One of its well-known side effects is causing urine to turn a red-orange color. This discoloration is harmless and typically resolves once the medication is discontinued. However, patients should be informed about this effect to avoid unnecessary concern.