A nurse is reviewing the arterial blood gas values for a client. The nurse should recognize that the values indicate which of the following acid-base imbalances?

The values are:

• pH: 7.56
• PaCO2: 55 mmHg
• HCO3: 33 mEq/L

Normal ranges:

• pH: 7.35-7.45
• PaCO2: 35-45 mmHg
• HCO3: 22-28 mEq/L

Choice A Reason:

Urinary tract infections (UTIs) are typically caused by bacteria entering the urinary tract. While strict bed rest can increase the risk of UTIs due to factors like catheter use and reduced mobility, the use of an incentive spirometer does not directly prevent UTIs. Instead, preventing UTIs involves maintaining good hygiene, ensuring adequate fluid intake, and, if necessary, using catheters properly.

Choice B Reason:

Deep vein thrombosis (DVT) is a condition where blood clots form in the deep veins, usually in the legs. This can occur due to prolonged immobility, such as strict bed rest after surgery. Preventing DVT involves measures like using compression stockings, administering anticoagulant medications, and encouraging leg exercises. An incentive spirometer, which is used to improve lung function, does not directly prevent DVT.

Choice C Reason:

Constipation is a common issue for patients on bed rest due to reduced physical activity and changes in diet. Preventing constipation involves ensuring adequate hydration, providing a high-fiber diet, and encouraging as much physical activity as possible. The use of an incentive spirometer, which focuses on respiratory function, does not directly address constipation.

Choice D Reason:

Atelectasis is a condition where the alveoli in the lungs collapse, leading to reduced or absent breath sounds in the affected areas. This is a common postoperative complication, especially in patients on strict bed rest, due to shallow breathing and reduced lung expansion. The use of an incentive spirometer encourages deep breathing and helps to keep the alveoli open, thereby preventing atelectasis. This is why the incentive spirometer is an essential tool for postoperative respiratory care.

Choice A Reason:

“N95 (personal respirator mask)” is correct because varicella (chickenpox) is an airborne disease. The N95 mask is designed to filter out at least 95% of airborne particles, making it essential for protecting healthcare workers from inhaling infectious agents.

Choice B Reason:

“Surgical mask” is incorrect because while surgical masks provide a barrier against large respiratory droplets, they do not offer sufficient protection against airborne particles. Varicella can be transmitted through tiny airborne droplets, which necessitates the use of an N95 mask.

Choice C Reason:

“They don’t need a mask” is incorrect because healthcare workers must wear appropriate personal protective equipment (PPE) to prevent the spread of infectious diseases. Not wearing a mask would put the nurse at risk of contracting varicella.

Choice D Reason:

“Only the client needs a mask” is incorrect because while it is important for the client to wear a mask to reduce the spread of infectious droplets, the nurse also needs to wear an N95 mask to protect themselves from airborne transmission.