A nurse is conducting a preoperative interview with a client who is scheduled for surgery.
The client states that he takes acetylsalicylic acid 81 mg. by mouth daily.
Prior to the client's upcoming surgery, the nurse should instruct the client to do which of the following?

Choice A rationale:

The client's arterial blood gas (ABG) results indicate a low pH (acidemia) and high PaCO2, which is characteristic of respiratory acidosis. Respiratory acidosis occurs when there is inadequate removal of carbon dioxide (CO2) from the body, leading to an accumulation of CO2 and a decrease in pH. In this case, the high PaCO2 (50 mm Hg) indicates that the client is retaining carbon dioxide, likely due to impaired ventilation. The normal pH range is 7.35 to 7.45, and the normal PaCO2 range is 35 to 45 mm Hg. These ABG values reflect an acid-base imbalance in the respiratory system, specifically, respiratory acidosis.

Choice B rationale:

Metabolic alkalosis is characterized by an elevated pH and an increase in bicarbonate (HCO3) levels. This is not the condition described in the client's ABG results, as the pH is low (acidemic) and HCO3 levels are within the normal range (24 mEq/L).

Choice C rationale:

Metabolic acidosis is characterized by a low pH and a decreased HCO3 level. The client's ABG results do not align with metabolic acidosis since the pH is low (acidemic) and the HCO3 level is within the normal range (24 mEq/L).

Choice D rationale:

Respiratory alkalosis is characterized by a high pH and low PaCO2. The client's ABG results do not match this condition as the pH is low (acidemic) and the PaCO2 is high (50 mm Hg), indicating respiratory acidosis. Therefore, choice A, respiratory acidosis, is the correct interpretation of the ABG results.

Choice A rationale:

The nurse should identify that the client needs liver function tests while taking pyrazinamide. Pyrazinamide is one of the drugs used to treat tuberculosis, and it is known to potentially cause hepatotoxicity (liver damage). Regular monitoring of liver function tests, including liver enzymes like ALT and AST, is essential to detect any liver-related issues early and ensure the client's safety during the medication therapy.

Choice B rationale:

Thyroid function studies are not typically necessary while a client is taking pyrazinamide. Pyrazinamide is not known to have a direct effect on thyroid function.

Choice C rationale:

Blood glucose levels do not need to be monitored specifically due to pyrazinamide therapy. Although some antituberculosis drugs may affect blood sugar levels, pyrazinamide is not a common culprit for such side effects.

Choice D rationale:

Gallbladder studies are not typically indicated while taking pyrazinamide. Pyrazinamide is not known to cause specific issues related to the gallbladder. Monitoring liver function is more critical due to its potential hepatotoxicity.