A nurse is working with a client who reports following holistic practices at home. The nurse should identify that which of the following is an example of a holistic practice that the client might follow?

Choice A reason: OCD behaviors, like picking up after others, are driven by internal compulsions, not intentional manipulation. These actions aim to reduce anxiety from obsessive thoughts, not control others. This choice misinterprets the compulsive nature of OCD, making it incorrect.

Choice B reason: Limiting interaction time is not the primary purpose of OCD behaviors. Picking up after others is a compulsive act to alleviate anxiety, not a deliberate strategy to avoid socializing. This choice does not reflect the psychological mechanism of OCD, making it incorrect.

Choice C reason: In OCD, compulsive behaviors like cleaning are performed to reduce anxiety caused by obsessive thoughts, such as fears of disorder or contamination. Picking up after others temporarily lowers distress by satisfying the compulsion, aligning with OCD’s core mechanism, making this the correct choice.

Choice D reason: OCD compulsions are not about focusing on meaningful tasks but about relieving anxiety from intrusive thoughts. Picking up after others is driven by the need to control obsessive fears, not to engage in productive activities, making this choice incorrect.

Choice A reason: Vomiting typically leads to metabolic alkalosis, not acidosis. It causes loss of hydrochloric acid from the stomach, reducing hydrogen ion concentration in the blood. This elevates blood pH above 7.45, as the body retains bicarbonate. The kidneys attempt to compensate by excreting excess bicarbonate, but this does not result in metabolic acidosis, making this choice incorrect.

Choice B reason: Thiazide diuretics increase sodium and water excretion, which can lead to mild metabolic alkalosis due to increased bicarbonate reabsorption in the kidneys. They do not cause a loss of bicarbonate or accumulation of acids, which are necessary for metabolic acidosis. Thus, this choice is incorrect as it does not contribute to an acidic blood state.

Choice C reason: Salicylate intoxication, such as from aspirin overdose, causes metabolic acidosis by increasing acid production. Salicylates stimulate the respiratory center, leading to hyperventilation and respiratory alkalosis initially, but they also disrupt mitochondrial function, causing lactic acid accumulation. This lowers blood pH below 7.35, meeting the criteria for metabolic acidosis, making this choice correct.

Choice D reason: Diarrhea results in significant bicarbonate loss through the stool, as the intestines secrete bicarbonate to neutralize gastric acid. This loss reduces the blood’s buffering capacity, lowering pH below 7.35, indicative of metabolic acidosis. The body may attempt to compensate via hyperventilation to reduce CO2, but the primary issue is bicarbonate depletion, making this choice correct.