A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?

A. Respiratory alkalosis is characterized by a high pH (alkaline) and a low PaCO2 (<35 mm Hg). The ABG results provided show a pH of 7.3 (which is acidic) and a PaCO2 of 50 mm Hg (which is elevated). Therefore, these results do not indicate respiratory alkalosis.
B. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3-). The ABG results show a pH of 7.3 (acidic), which aligns with metabolic acidosis. However, the PaCO2 of 50 mm Hg is elevated, which typically indicates respiratory compensation for the metabolic acidosis.
C. Metabolic alkalosis is characterized by a high pH and an elevated bicarbonate (HCO3-). The ABG results show a pH of 7.3 (acidic), which does not suggest metabolic alkalosis.
D. Respiratory acidosis is characterized by a low pH and an elevated PaCO2 (>45 mm Hg). The ABG results provided show a pH of 7.3 (acidic) and a PaCO2 of 50 mm Hg (elevated). These findings are consistent with respiratory acidosis, where the elevated PaCO2 indicates retention of carbon dioxide, leading to acidosis.

A. Furosemide can increase serum uric acid levels, leading to hyperuricemia. This occurs due to the drug's effects on renal excretion of uric acid. Hyperuricemia can predispose the client to gouty arthritis or kidney stones.
B. Furosemide typically leads to sodium loss (natriuresis) rather than hypernatremia. It is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending loop of Henle in the kidneys, promoting diuresis and reducing fluid overload.
C. Furosemide-induced diuresis can cause loss of chloride ions along with sodium, potentially leading to hypochloremia rather than hyperchloremia. Hyperchloremia is less common unless there are other contributing factors such as concurrent administration of saline solutions or underlying conditions.
D. Furosemide does not typically cause hypercalcemia. In fact, it can lead to mild hypocalcemia due to increased urinary calcium excretion. Loop diuretics like furosemide impair calcium reabsorption in the kidneys, which can lead to calcium wasting.