A nurse is collecting data on a client who has dehydration. Which of the following findings should the nurse expect?

Choice A reason: Having the client place their head between their knees may help with some causes of hyperventilation, but it is not a standard treatment for respiratory alkalosis.

Choice B reason: Having the client breathe into a paper bag can help to rebreathe exhaled carbon dioxide, which can
help correct the low carbon dioxide levels seen in respiratory alkalosis.

Choice C reason: Insulin is not indicated for respiratory alkalosis as it is used for the management of hyperglycemia, not for correcting acid-base imbalances.

Choice D reason: Sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis, and could
exacerbate the alkalosis.

Choice A reason: A pleural friction rub is associated with conditions that cause pleural inflammation, such as pleuritis or pneumonia, rather than Chronic Obstructive Pulmonary Disease (COPD). While patients with COPD may experience other abnormal lung sounds like wheezing or crackles, pleural friction rubs are not typically a feature of COPD.

Choice B reason: Peripheral edema is a common finding in clients with advanced COPD, particularly in those who develop right-sided heart failure (also known as cor pulmonale). The prolonged hypoxia and pulmonary hypertension that often accompany COPD can put additional strain on the right side of the heart, leading to fluid retention and swelling in the extremities. This is a typical finding in later stages of COPD.

Choice C reason: Spoon nails (koilonychia) are typically associated with iron deficiency anemia or other conditions affecting the circulatory system. Although COPD is a chronic respiratory condition that can impact oxygenation, spoon nails are not commonly associated with COPD. This condition is more commonly seen in anemia or other nutritional deficiencies.

Choice D reason:

Hyperresonance on percussion is a typical finding in COPD, especially in those with emphysema, where air trapping occurs. This is due to the destruction of lung tissue and the over-inflation of alveoli, which creates a more resonant sound when the chest is percussed. This finding indicates the presence of hyperinflated lungs, a hallmark of emphysema and a common component of COPD.