A nurse is caring for a client who is hyperventilating and has the following ABG results: pH 7.50 (7.35 to 7.45), PaCO₂ 29 mm Hg (35 to 45 mm Hg), and HCO₃ 25 mEq/L (21 to 28 mEq/L). The nurse should identify that the client has which of the following acid-base imbalances?

Choice A Reason

4g sodium diet. While reducing sodium intake is important for managing chronic kidney disease (CKD), a specific 4g sodium diet is not typically prescribed. Instead, patients are generally advised to limit sodium intake to less than 2,300 milligrams per day to help control blood pressure and reduce fluid retention.

Choice B Reason

Potassium-restricted diet. This is the correct intervention. Patients with CKD often have difficulty excreting potassium, leading to hyperkalemia, which can be dangerous. Therefore, a potassium-restricted diet is commonly recommended to maintain normal serum potassium levels.

Choice C Reason

High-phosphorus diet. This statement is incorrect. Patients with CKD are usually advised to limit phosphorus intake because their kidneys cannot effectively excrete phosphorus, leading to hyperphosphatemia. High phosphorus levels can cause bone and cardiovascular problems.

Choice D Reason

High-protein diet. This statement is incorrect. While protein is essential, excessive protein intake can increase the workload on the kidneys. Patients with CKD are often advised to follow a moderate protein diet to reduce the production of waste products that the kidneys need to filter.

Choice A Reason

Determine the time the last dose of pain medication was administered. While it is important to know when the last dose of pain medication was given, assessing the client’s current pain level is a priority. This helps in understanding the severity and nature of the pain, which guides further interventions.

Choice B Reason

Reposition the client to assist with reduction of pain. Repositioning can help alleviate pain, but it should be done after assessing the pain. Without understanding the pain’s characteristics, repositioning might not address the underlying issue effectively.

Choice C Reason

Ask the client to describe the pain and rate it on a scale of 0 to 10. This is the correct first action. Pain assessment is crucial in determining the appropriate intervention. By asking the client to describe and rate their pain, the nurse can tailor the pain management plan to the client’s specific needs.

Choice D Reason

Check the client’s medical record for type of PRN pain medication. Reviewing the medical record for PRN pain medication is important, but it should follow the initial pain assessment. Knowing the pain’s intensity and characteristics will help in deciding whether PRN medication is needed.