A nurse is caring for a client who has a prescription for diltiazem. The nurse measures the client's vital signs and notes that the client's apical heart rate is 49/min. The nurse should prepare to administer which of the following medications?

Answer: C. Respiratory acidosis

Rationale:

A) Metabolic acidosis: This occurs when there is an excess of acid in the body or a loss of bicarbonate, often due to conditions such as renal failure or severe diarrhea. In chronic bronchitis, the primary issue is related to respiratory function rather than metabolic disturbances.

B) Respiratory alkalosis: This condition results from hyperventilation, leading to excessive loss of carbon dioxide. It is unlikely in a client with chronic bronchitis, who typically experiences difficulty in exhaling fully rather than hyperventilating.

C) Respiratory acidosis: In chronic bronchitis, airflow obstruction and reduced gas exchange can lead to carbon dioxide retention, resulting in respiratory acidosis. Symptoms like dyspnea and increased work of breathing support this imbalance, as the body is unable to adequately expel carbon dioxide.

D) Metabolic alkalosis: This imbalance results from excessive bicarbonate or loss of hydrogen ions, often related to prolonged vomiting or diuretics. It is not characteristic of chronic bronchitis, where the primary concern is respiratory function rather than metabolic processes.

A. Small for gestational age:

While being small for gestational age can contribute to respiratory difficulties in newborns, it is not directly associated with respiratory distress syndrome or respiratory acidosis. Other factors, such as prematurity or intrauterine growth restriction, may play a more significant role.

B. Cesarean birth:

Cesarean birth can predispose newborns to respiratory difficulties, including respiratory distress syndrome. During vaginal birth, the compression of the chest during passage through the birth canal helps expel lung fluid, whereas babies born via cesarean section may have more retained lung fluid, leading to respiratory distress.

C. Ventricular septal defect:

Ventricular septal defect is a congenital heart defect and is not directly associated with respiratory distress syndrome or respiratory acidosis. However, congenital heart defects can affect the cardiovascular system, leading to respiratory compromise in some cases.

D. Maternal history of asthma:

While maternal asthma can increase the risk of respiratory problems in newborns, it is not directly related to respiratory distress syndrome or respiratory acidosis. Maternal asthma may increase the likelihood of the newborn developing asthma or other respiratory conditions later in life.