A nurse is caring for a client on postoperative day 2 following abdominal surgery. The surgeon prescribes a full liquid diet. Which food choice would be contraindicated for this client?

Choice A reason: Metabolic acidosis is characterized by a decrease in blood pH due to an accumulation of acids or a loss of bicarbonate. It can result from conditions such as diabetic ketoacidosis, renal failure, or severe diarrhea. However, it is not typically associated with opioid overdose. Opioid overdose primarily affects the respiratory system, leading to hypoventilation and respiratory acidosis.

Choice B reason: Respiratory acidosis occurs when there is an accumulation of carbon dioxide (CO2) in the blood due to hypoventilation. Opioid overdose depresses the central nervous system, leading to decreased respiratory rate and depth, which causes CO2 retention. This results in a decrease in blood pH, leading to respiratory acidosis. Symptoms may include confusion, lethargy, and shortness of breath.

Choice C reason: Respiratory alkalosis is characterized by a decrease in blood CO2 levels due to hyperventilation. It can occur in conditions such as anxiety, fever, or high altitude. Opioid overdose, however, causes hypoventilation rather than hyperventilation, making respiratory alkalosis an unlikely outcome.

Choice D reason: Metabolic alkalosis is characterized by an increase in blood pH due to an accumulation of bicarbonate or a loss of acids. It can result from conditions such as prolonged vomiting, diuretic use, or excessive bicarbonate intake. Opioid overdose does not typically lead to metabolic alkalosis. The primary concern with opioid overdose is respiratory depression and the resulting respiratory acidosis.

Choice A reason: Reminding the client that a signed informed consent form is a legally binding document is incorrect. Informed consent is based on the principle of patient autonomy, meaning the patient has the right to withdraw consent at any time. The nurse should respect the client’s decision and not pressure them into proceeding with the procedure.

Choice B reason: Notifying the surgeon that the client wishes to withdraw informed consent for the procedure is the appropriate action. The surgeon needs to be informed immediately so that they can discuss the client’s concerns, provide additional information if needed, and respect the client’s decision. This ensures that the client’s autonomy and rights are upheld.

Choice C reason: Proceeding with preparation of the patient for the surgical procedure is not appropriate once the client has withdrawn consent. Continuing with the preparation would violate the client’s rights and could lead to legal and ethical issues. The nurse must halt any further preparation and inform the relevant medical staff of the client’s decision.

Choice D reason: Informing the surgical team to cancel the client’s surgery is a step that may be taken after discussing the withdrawal of consent with the surgeon. The nurse should first notify the surgeon, who will then make the decision to cancel the surgery based on the client’s wishes. Directly informing the surgical team without consulting the surgeon first is not the correct protocol.