A nurse is assessing a client who has respiratory failure. Which of the following manifestations should the nurse identify as indicative of severe hypercapnia?

A. Resorption of cerebrospinal fluid: Cerebrospinal fluid resorption is primarily regulated by pressure gradients within the brain and the arachnoid villi, not directly by mean arterial pressure.
B. Cerebral blood flow: Mean arterial pressure is a key factor in maintaining adequate cerebral perfusion. The brain requires a consistent blood supply, and if MAP falls too low, cerebral perfusion pressure drops, increasing the risk for brain ischemia and secondary injury after trauma.
C. Regulation of blood pressure: MAP is a measurement derived from blood pressure values, not a mechanism that regulates blood pressure itself. It reflects perfusion status rather than controlling it.
D. The client's intake and output needs: Intake and output are managed through fluid balance and kidney function. While MAP may indirectly influence renal perfusion, it is not the primary determinant of fluid management planning.

A. Frequent handwashing: This is an important strategy to prevent infections, which can trigger a sickle cell crisis. Clients with sickle cell disease are more susceptible to infections due to their compromised immune system, so teaching frequent handwashing can significantly reduce the risk of infection-related complications.
B. Avoiding the annual flu vaccine: Clients with sickle cell disease should not avoid the annual flu vaccine. In fact, the flu vaccine is strongly recommended for individuals with sickle cell disease to prevent influenza, which can increase the risk of complications. Avoiding it would place the client at greater risk for respiratory infections.
C. Taking an iron supplement daily: Sickle cell disease often leads to anemia, but iron supplementation is generally not recommended unless the client has a confirmed iron deficiency. In many cases, iron overload can occur, especially if the client has frequent blood transfusions. It is essential to assess iron levels before recommending supplements.
D. Visiting the eye doctor annually: Clients with sickle cell disease are at an increased risk for eye problems, such as retinopathy. Annual eye exams are crucial to detect early signs of complications and prevent vision loss. Regular monitoring helps maintain overall eye health and provides early intervention if needed.
E. Joining a support group: Sickle cell disease can be emotionally and physically challenging. Joining a support group can provide the client with emotional support, practical coping strategies, and connections with others who have similar experiences. This is an essential aspect of overall well-being in managing the condition.