A client diagnosed with pancreatitis reports severe epigastric pain. After administering a narcotic analgesic, the client insists on Tip sitting up and leaning forward. Which action should the nurse implement?

A. Provide a bedside table for the client to lean across. Clients with acute pancreatitis often experience severe epigastric pain that radiates to the back. Leaning forward helps reduce pressure on the inflamed pancreas and relieves pain by minimizing peritoneal irritation. Providing a bedside table allows the client to rest in a comfortable, supported position, improving pain management without additional interventions.
B. Place bed in the reverse Trendelenburg position. Reverse Trendelenburg elevates the head and lowers the feet, which does not specifically relieve pain associated with pancreatitis. The client instinctively leans forward for relief, and adjusting the bed position would not provide the same benefit. This intervention does not directly address the underlying cause of discomfort.
C. Encourage bed rest until analgesic takes effect. Although pain control is essential, keeping the client in a supine or bedrest position can increase abdominal pressure and worsen discomfort. Allowing the client to assume a comfortable position enhances the effectiveness of analgesics and prevents unnecessary distress. Pain relief strategies should focus on both pharmacologic and positioning interventions.
D. Raise the head of the bed to a 90-degree angle. Elevating the head of the bed can improve breathing and reduce reflux, but it does not provide the same pressure relief as leaning forward. Sitting upright without forward support does not effectively relieve peritoneal irritation from pancreatic inflammation. Providing a bedside table supports proper positioning and enhances comfort.

A. pH 7.25 and HCO₃⁻ 18 mEq/L. A pH of 7.25 is still acidotic, and a bicarbonate level of 18 mEq/L is below the normal range (22–26 mEq/L), indicating persistent metabolic acidosis. This suggests that ketoacidosis is not fully resolved, requiring continued insulin therapy, hydration, and electrolyte management.
B. pH 7.30 and HCO₃⁻ 20 mEq/L. While this shows partial improvement, the pH remains below 7.35, indicating ongoing mild acidosis. The bicarbonate level is still below normal, suggesting that buffering capacity is not yet fully restored. Additional treatment is required to completely normalize acid-base balance.
C. pH 7.38 and HCO₃⁻ 24 mEq/L. A pH of 7.38 falls within the normal range (7.35–7.45), indicating that acidosis has resolved. The bicarbonate level of 24 mEq/L is within normal limits, confirming that the body’s buffering system has been restored. These values suggest that ketoacidosis has resolved, and treatment has been effective.
D. pH 7.20 and HCO₃⁻ 15 mEq/L. A pH of 7.20 indicates severe metabolic acidosis, and a bicarbonate level of 15 mEq/L shows a significant loss of buffering capacity. These values suggest uncontrolled DKA or worsening acidosis, requiring urgent intervention with continued insulin therapy, fluid resuscitation, and electrolyte replacement.