A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching?
 

Choice A reason: pH 7.30 with elevated HCO3- and PaCO2 suggests compensated respiratory acidosis, not typical for chronic kidney disease.

Choice B reason: pH 7.55 with elevated HCO3- and low PaCO2 suggests metabolic alkalosis, which is not typical for chronic kidney disease.

Choice C reason: pH 7.25 with decreased HCO3- and PaCO2 suggests metabolic acidosis, which is expected in chronic kidney disease due to the accumulation of acids.

Choice D reason: pH 7.50 with low HCO3- and PaCO2 suggests compensated metabolic alkalosis, which is not typical for chronic kidney disease.

The correct answer is Choice A

Choice A rationale: Headache and restlessness can be signs of a seizure or neurological disturbance, which phenytoin is used to treat. Phenytoin is an anticonvulsant medication that helps control seizures by stabilizing neuronal membranes and reducing excitability.

Choice B rationale: Decreased blood pressure and rapid pulse are not indications for phenytoin administration. These symptoms may suggest hypotension or cardiovascular issues, which require different interventions such as fluid resuscitation or vasopressors.

Choice C rationale: Muscle cramps and chest heaviness are not treated with phenytoin. These symptoms could indicate electrolyte imbalances or cardiac issues, which need specific treatments like electrolyte replacement or cardiac monitoring.

Choice D rationale: Pain and tingling at the access site are not indications for phenytoin administration. These symptoms may suggest local irritation or infection at the dialysis access site, requiring appropriate wound care or antibiotics.