A nurse is reinforcing preoperative teaching with a client who is to undergo a bowel resection at 1300 next week. Which of the following statements client indicates to the nurse a need for further teaching?

A. Have the client place their head between their knees:

Placing the head between the knees may help alleviate symptoms of hyperventilation by promoting relaxation and reducing dizziness. This position can help increase venous return to the heart and improve cerebral blood flow, which may reduce symptoms associated with hyperventilation.

B. Plan to administer sodium bicarbonate to the client:

Sodium bicarbonate is not indicated for respiratory alkalosis. It is used to treat metabolic acidosis by increasing plasma bicarbonate levels. Administering sodium bicarbonate to a client with respiratory alkalosis may exacerbate the alkalosis by further increasing the pH of the blood.

C. Plan to administer insulin to the client:

Insulin administration is not indicated for respiratory alkalosis. Insulin is used to manage hyperglycemia in diabetes mellitus and does not address the underlying respiratory condition causing alkalosis.

D. Have the client breathe into a paper bag:

Breathing into a paper bag is a common intervention for managing hyperventilation associated with respiratory alkalosis. Rebreathing exhaled carbon dioxide helps increase carbon dioxide levels in the blood, which can reverse the alkalosis and alleviate symptoms of hyperventilation.

(A) Decreased stimulation of the sympathetic nervous system (SNS): The sympathetic nervous system (SNS) plays a key role in regulating blood pressure. When the SNS is stimulated, it causes vasoconstriction, or narrowing of the blood vessels, which increases blood pressure. Therefore, decreased stimulation of the SNS would typically lead to vasodilation, or widening of the blood vessels, which would lower blood pressure, not increase it.

(B) Decreased elasticity of blood vessels: As people age, their blood vessels can lose elasticity, which can lead to hypertension. When blood vessels are elastic, they can easily expand and contract with each heartbeat, maintaining a healthy blood pressure. But when they become stiff or rigid, they can’t expand as easily, causing the pressure inside to increase.

(c) Increased peripheral vascular resistance (PVR): Peripheral vascular resistance is the resistance that blood must overcome to flow through the blood vessels. The more resistance, the harder the heart has to work to pump blood through the body, which can lead to increased blood pressure. Factors that can increase PVR include vasoconstriction, or narrowing of the blood vessels, and increased blood viscosity, or thickness.

(D) Decreased fluid volume: Decreased fluid volume, or hypovolemia, would typically lead to a decrease in blood pressure, not an increase. This is because blood pressure is directly related to the volume of blood in the blood vessels. When there’s less blood, the pressure inside the blood vessels is usually lower.

(E) Increased blood viscosity: Blood viscosity refers to the thickness of the blood. When blood is thicker, it’s harder for it to flow through the blood vessels, which increases the resistance to blood flow, leading to increased blood pressure.