A nurse is caring for a client who has hypernatremia. Which of the following actions should the nurse take? (Select all that apply.)

Choice A reason:

Type I hypersensitivity is not involved in Graves' disease, as it does not involve IgE antibodies or mast cells.

Choice B reason:

Type II hypersensitivity is involved in Graves' disease, as it involves IgG antibodies that bind to the thyroid-stimulating hormone (TSH) receptors on the thyroid gland and stimulate the production of thyroid hormones. This leads to hyperthyroidism and manifestations such as goiter, exophthalmos, tachycardia, weight loss, or tremors.

Choice C reason:

Type III hypersensitivity is not involved in Graves' disease, as it does not involve immune complexes or complement activation.

Choice D reason:

Type IV hypersensitivity is not involved in Graves' disease, as it does not involve cytotoxic T cells or helper T cells.

Choice E reason:

Type V hypersensitivity is also involved in Graves' disease, as it involves the stimulation of target cells by antibodies that act as agonists for cell surface receptors. This leads to an increased function of the target organ or tissue.

Choice A reason:

Administering antiemetics as prescribed is an intervention that the nurse should implement for a client who has metabolic alkalosis due to prolonged vomiting. Antiemetics are medications that can prevent or treat nausea and vomiting, which are the main causes of metabolic alkalosis in this case. By stopping vomiting, antiemetics can help prevent further loss of gastric acid and bicarbonate retention, which can correct metabolic alkalosis.

Choice B reason:

Monitoring serum potassium levels is an intervention that the nurse should implement for a client who has metabolic alkalosis due to prolonged vomiting. Metabolic alkalosis can cause hypokalemia due to increased renal excretion of potassium and intracellular shift of potassium in exchange for hydrogen ions. Hypokalemia can worsen metabolic alkalosis by impairing renal acid excretion and increasing bicarbonate reabsorption. The nurse should monitor serum potassium levels regularly and report any abnormalities or signs of hypokalemia, such as muscle weakness, cramps, arrhythmias, or ECG changes.

Choice C reason:

Administering sodium bicarbonate IV as prescribed is not an intervention that the nurse should implement for a client who has metabolic alkalosis due to prolonged vomiting. Sodium bicarbonate is an alkalinizing agent that can increase serum bicarbonate levels and pH, which can worsen metabolic alkalosis. Sodium bicarbonate IV should be avoided or used with caution in clients who have metabolic alkalosis, unless they have severe acid-base imbalance or coexisting metabolic acidosis.

Choice D reason:

Encouraging intake of acidic foods and beverages is not an intervention that the nurse should implement for a client who has metabolic alkalosis due to prolonged vomiting. Acidic foods and beverages can lower the pH of the stomach, but they have little effect on the pH of the blood or urine, which are regulated by other mechanisms such as buffers, lungs, and kidneys. Acidic foods and beverages can also irritate the gastric mucosa and trigger more vomiting, which can aggravate metabolic alkalosis.

Choice E reason:

Providing supplemental oxygen as needed is an intervention that the nurse should implement for a client who has metabolic alkalosis due to prolonged vomiting. Metabolic alkalosis can cause respiratory compensation by decreasing the respiratory rate and depth, which can lead to hypoxemia and hypercapnia. Supplemental oxygen can help maintain adequate oxygenation and prevent tissue hypoxia and organ damage. The nurse should monitor the client's oxygen saturation and arterial blood gas levels and adjust the oxygen therapy accordingly.