A nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? (Select all that apply)

Choice a reason:
Placing the client on 2L via nasal cannula is a common intervention for hypoxemia, but with the client's pulse oximetry at 88%, which is below the normal range of 95-100%, and the presence of tachypnea, a more immediate assessment of the client's respiratory status is warranted. Oxygen therapy should be guided by the results of arterial blood gas (ABG) analysis to tailor the treatment to the client's specific needs.

Choice b reason:
Obtaining a blood glucose level is not the most immediate concern in the context of altered mental status and respiratory distress. While it is important to rule out hypoglycemia as a cause of altered mental status, the primary concern indicated by the vital signs is the client's respiratory condition.

Choice c reason:
Calling the physician for an order for a stat arterial blood gas is the most appropriate action. The ABG will provide detailed information about the client's oxygenation, carbon dioxide levels, and acid-base balance. This is crucial for a client with a new onset change in mental status and tachypnea, as it can indicate respiratory failure or other serious complications of pneumonia.

Choice d reason:
Requesting an order for lorazepam is not appropriate given the client's current respiratory status. Lorazepam, a benzodiazepine, can depress the central nervous system and respiratory drive, potentially worsening the client's hypoxemia and respiratory effort.

Choice A Reason:
Abdominal distention is a common finding in large bowel obstruction due to the accumulation of intestinal contents, gas, and fluid proximal to the obstruction site. This can lead to a visibly swollen abdomen and is often accompanied by discomfort or pain.

Choice B Reason:
Hypoactive bowel sounds are expected in large bowel obstruction as the peristaltic activity decreases below the point of obstruction. Initially, bowel sounds may be high-pitched or tinkling due to the intestine's attempt to move contents past the obstruction, but as the condition progresses, the sounds become less frequent or even absent.

Choice C Reason:
Diarrhea is not typically associated with large bowel obstruction. In fact, constipation or cessation of stool is a more common symptom. If diarrhea occurs, it may be due to a partial obstruction or the presence of liquid stool that can pass around the blockage.

Choice D Reason:
Fever may indicate a complication of large bowel obstruction, such as ischemia or perforation, leading to infection and inflammation. However, fever is not a primary symptom of uncomplicated large bowel obstruction and should prompt immediate further investigation.