A client is admited to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs?

Choice A: Measure body weight every day is correct because body weight is an indicator of fluid balance and can help monitor the effectiveness of the medication. The nurse should instruct the patient to weigh themselves at the same time each day, preferably in the morning, and report any significant changes to the provider.

Choice B: Expect urination to increase is correct because furosemide is a diuretic that works by blocking the reabsorption of sodium and water in the kidneys, thus increasing urine output and reducing fluid volume. The nurse should instruct the patient to drink enough fluids to prevent dehydration and electrolyte imbalance and to avoid taking the medication at night to prevent nocturia and sleep disturbance.

Choice C: Taking the medication before going to sleep is incorrect because taking furosemide at night can cause nocturia and sleep disturbance, as well as increase the risk of falls. The nurse should instruct the patient to take the medication in the morning or early afternoon and to avoid caffeine and alcohol, which can also increase urination.

Choice D: Report swelling of the face or hands is correct because swelling of the face or hands can indicate an allergic reaction or angioedema, which are rare but serious side effects of furosemide. The nurse should instruct the patient to stop taking the medication and seek immediate medical attention if they experience swelling of the face or hands, as well as difficulty breathing, hives, or itching.

Choice E: Expecting to feel weak and dizzy is correct because weakness and dizziness are common side effects of furosemide, especially when starting or increasing the dose. The nurse should instruct the patient to rise slowly from a sitting or lying position and to use caution when driving or performing other activities that require alertness. The nurse should also instruct the patient to report any signs of hypotension, such as fainting, blurred vision, or chest pain.

Choice A Reason: This is incorrect because phosphorus is not the most affected electrolyte by acute renal failure. Phosphorus is a mineral that is involved in bone formation, energy metabolism, and acid-base balance. Acute renal failure can cause hyperphosphatemia, which is a high level of phosphorus in the blood, due to impaired excretion by the kidneys. However, hyperphosphatemia is usually asymptomatic and can be treated with phosphate binders and dietary restriction.

Choice B Reason: This is incorrect because magnesium is not the most affected electrolyte by acute renal failure. Magnesium is a mineral that is essential for nerve and muscle function, blood pressure regulation, and bone health. Acute renal failure can cause hypermagnesemia, which is a high level of magnesium in the blood, due to impaired excretion by the kidneys. However, hypermagnesemia is rare and usually occurs in patients who receive excessive magnesium supplementation or antacids.

Choice C Reason: This is correct because potassium is the most affected electrolyte by acute renal failure. Potassium is a mineral that is vital for nerve and muscle function, especially for the heart. Acute renal failure can cause hyperkalemia, which is a high level of potassium in the blood, due to impaired excretion by the kidneys. Hyperkalemia can cause muscle weakness, cardiac arrhythmias, and cardiac arrest. The nurse should monitor the patient's vital signs, electrocardiogram, and serum potassium level, and administer medications or dialysis as ordered.

Choice D Reason: This is incorrect because calcium is not the most affected electrolyte by acute renal failure. Calcium is a mineral that is essential for muscle contraction, nerve transmission, and blood clotting. Acute renal failure can cause hypocalcemia, which is a low level of calcium in the blood, due to decreased production of active vitamin D by the kidneys. Hypocalcemia can cause tetany, seizures, and cardiac arrhythmias. The nurse should monitor the patient's vital signs, electrocardiogram, and Chvostek's and Trousseau's signs, and administer calcium and vitamin D supplements as ordered.

Choice E Reason: This is incorrect because sodium is not the most affected electrolyte by acute renal failure. Sodium is a mineral that regulates fluid balance, blood pressure, and nerve impulses. Acute renal failure can cause hyponatremia or hypernatremia, which are low or high levels of sodium in the blood, due to impaired regulation of water intake and output by the kidneys. Hyponatremia can cause confusion, seizures, and coma. Hypernatremia can cause thirst, agitation, and restlessness. The nurse should monitor the patient's fluid balance, vital signs, and serum sodium level, and administer fluids or diuretics as ordered.