The patient's Hemoglobin A1C today is 8.29% and was 7.59% three months ago. The reference range is 4 to 5.99%. What is the likely diagnosis?

The correct answer is choiceb. Identify the client using 2 client identifiers,c. Perform hand hygiene,e. Don gloves,f. Check the skin around the face, andg. Assess respiratory function.

Choice A rationale:

Determining if the client needs to go to the bathroom is not directly related to the immediate preparation for oxygen administration. However, it can be considered as part of overall patient comfort and care.

Choice B rationale:

Identifying the client using 2 client identifiers is crucial to ensure the correct patient is receiving the correct treatment, which is a standard safety protocol in healthcare settings.

Choice C rationale:

Performing hand hygiene is essential to prevent the spread of infection and maintain a sterile environment.

Choice D rationale:

Brushing the client’s teeth is not a necessary step before applying a simple face mask for oxygen administration. It is more related to general oral hygiene.

Choice E rationale:

Donning gloves is important to protect both the nurse and the patient from potential contamination and infection.

Choice F rationale:

Checking the skin around the face is important to ensure there are no existing sores or irritations that could be exacerbated by the mask.

Choice G rationale:

Assessing respiratory function is critical to determine the patient’s baseline respiratory status and to monitor the effectiveness of the oxygen therapy.

Choice A rationale:

Carbon dioxide is primarily eliminated through the lungs, not the kidneys. While the kidneys do play a role in acid-base balance, their primary mechanism for regulating pH is through the excretion or retention of bicarbonate ions (HCO3-), not carbon dioxide itself.

The kidneys' ability to compensate for respiratory acidosis is limited. In cases of severe respiratory acidosis, the kidneys may not be able to adequately compensate, leading to a further decrease in blood pH.

Choice B rationale:

Hyperventilation would actually decrease carbon dioxide levels in the blood, not increase them. Hyperventilation is a state of rapid, deep breathing that leads to increased exhalation of carbon dioxide. This can result in respiratory alkalosis, which is the opposite of respiratory acidosis.

Choice D rationale:

Low blood oxygen levels (hypoxia) can stimulate respiration, but this would not directly cause respiratory acidosis. In fact, hypoxia can sometimes lead to respiratory alkalosis due to hyperventilation.

Respiratory acidosis is primarily caused by impaired carbon dioxide elimination, not decreased oxygen levels.

Choice C rationale:

High levels of carbon dioxide in the blood (hypercapnia) are the hallmark feature of respiratory acidosis. This can occur due to a variety of factors that impair ventilation, such as:

Chronic obstructive pulmonary disease (COPD) Asthma

Pneumonia Sleep apnea

Neuromuscular disorders that affect breathing Drug overdose (e.g., opioids)

The accumulation of carbon dioxide in the blood leads to a decrease in blood pH, which can have a range of negative effects on the body's organ systems.