Which of the following medications from a client's medication list would increase their surgical risk?

A. Checking the cannula regularly helps to to ensure proper positioning and comfort.
B. Applying petroleum ointment to nares is not recommended; use water-based products instead.
C. Checking the tops of the ears for skin breakdown helps to prevent and address potential skin issues.
D. The oxygen flow rate should be monitored according to the healthcare provider's instructions, not just every other day, to make sure the prescribed amount is being received
E. A "no smoking" signs essential for safety due to the flammability of oxygen.

A. Metabolic acidosis is characterized by a primary decrease in bicarbonate (HCO₃⁻) levels, which is not typically a direct result of COPD. However, if a patient with COPD has an additional condition like kidney failure or severe sepsis, they could potentially develop metabolic acidosis. But, this is not the primary concern in COPD.
B. Respiratory alkalosis is caused by hyperventilation, where there is excessive loss of CO₂ leading to an increase in blood pH. This is less common in COPD patients, as they typically have difficulty exhaling CO₂ rather than hyperventilating.
C. Metabolic alkalosis involves an increase in blood pH due to elevated bicarbonate levels or loss of acid. This is not typically associated with COPD, unless there is an unrelated condition causing metabolic alkalosis.
D. COPD is characterized by impaired airflow and reduced ability to expel carbon dioxide (CO₂) effectively. As CO₂ accumulates in the blood, it combines with water to form carbonic acid, which lowers the blood pH, leading to respiratory acidosis.