A nurse is reinforcing teaching with a client about how to prevent the onset of manifestations of Raynaud's phenomenon. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

Answer: C. Respiratory acidosis

Rationale:

A) Metabolic acidosis: This occurs when there is an excess of acid in the body or a loss of bicarbonate, often due to conditions such as renal failure or severe diarrhea. In chronic bronchitis, the primary issue is related to respiratory function rather than metabolic disturbances.

B) Respiratory alkalosis: This condition results from hyperventilation, leading to excessive loss of carbon dioxide. It is unlikely in a client with chronic bronchitis, who typically experiences difficulty in exhaling fully rather than hyperventilating.

C) Respiratory acidosis: In chronic bronchitis, airflow obstruction and reduced gas exchange can lead to carbon dioxide retention, resulting in respiratory acidosis. Symptoms like dyspnea and increased work of breathing support this imbalance, as the body is unable to adequately expel carbon dioxide.

D) Metabolic alkalosis: This imbalance results from excessive bicarbonate or loss of hydrogen ions, often related to prolonged vomiting or diuretics. It is not characteristic of chronic bronchitis, where the primary concern is respiratory function rather than metabolic processes.

A. "Report any incidents of swelling to your lips, tongue or face."

Angioedema is a serious side effect of lisinopril, which is an ACE inhibitor. Swelling of the lips, tongue, or face can indicate angioedema, which can be life-threatening and requires immediate medical attention.

B. "Report the development of a persistent dry cough."

A persistent dry cough is a common side effect of ACE inhibitors like lisinopril. If this occurs, the healthcare provider should be notified as an alternative medication may be needed.

C. "Your cholesterol levels should be monitored monthly while taking this medication."

Monitoring cholesterol levels is not typically necessary for clients taking lisinopril. This instruction is more relevant for medications affecting lipid levels, such as statins.

D. "Make sure your diet contains a lot of potassium-rich foods."

Lisinopril can cause hyperkalemia (high potassium levels). Therefore, it is important to avoid excessive intake of potassium-rich foods to prevent complications. Clients should be advised to monitor potassium intake rather than increase it.

E. "Monitor your blood pressure on a regular basis."

Regular monitoring of blood pressure is essential for clients taking lisinopril to ensure the medication is effectively managing their hypertension and to adjust dosages as necessary.