A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?

Choice A reason: Allergic reactions typically present with symptoms like rash, itching, or anaphylaxis, not jaundice, dark urine, or light stools. These symptoms indicate hepatobiliary dysfunction, not an immune-mediated response. Allergic reactions don’t typically affect liver function or bile excretion, making this choice inconsistent with the patient’s clinical presentation.

Choice B reason: Idiosyncratic drug effects on bone marrow cause hematologic issues like anemia or leukopenia, not jaundice or light stools. These symptoms suggest liver dysfunction, as bile pigment changes cause dark urine and pale stools. Bone marrow effects don’t explain the hepatobiliary symptoms, making this choice incorrect.

Choice C reason: Iatrogenic skin disease might involve rashes or lesions, but jaundice, dark urine, and light stools point to liver or bile duct issues. These symptoms result from impaired bilirubin metabolism, not cutaneous pathology. This choice doesn’t align with the systemic hepatobiliary symptoms described, making it incorrect.

Choice D reason: Drug-induced liver toxicity, such as from acetaminophen or statins, impairs bilirubin metabolism, causing jaundice, dark urine (bilirubinuria), and light stools (reduced bile). Malaise, nausea, and vomiting reflect systemic effects of liver dysfunction. This matches the patient’s symptoms, making it the most likely diagnosis and correct choice.

Choice A reason: Uncompensated respiratory alkalosis requires low PaCO2 (<35 mm Hg) and high pH (>7.45). Here, PaCO2 is 48 mm Hg (high) and HCO3- is 29 mEq/L (high), indicating a metabolic cause with respiratory compensation, making this choice incorrect.

Choice B reason: Partially compensated respiratory alkalosis involves low PaCO2 and high HCO3- with high pH. With PaCO2 at 48 mm Hg (high) and HCO3- at 29 mEq/L, the alkalosis is metabolic, with elevated PaCO2 as compensation, making this choice incorrect.

Choice C reason: pH 7.48 (alkalotic), PaCO2 48 mm Hg (high), and HCO3- 29 mEq/L (high) indicate metabolic alkalosis (high HCO3-), with elevated PaCO2 showing partial respiratory compensation (hypoventilation to retain CO2). This matches partially compensated metabolic alkalosis, making it the correct choice.

Choice D reason: Uncompensated metabolic alkalosis requires high pH and high HCO3- with normal PaCO2. Here, PaCO2 is 48 mm Hg (high), indicating respiratory compensation, not an uncompensated state. This makes the condition partially compensated, so this choice is less accurate than C.