A patient is taking a drug that has known toxic side effects. What will the nurse do?

Choice A: Hypoventilation

Hypoventilation refers to inadequate ventilation that leads to an increased concentration of carbon dioxide (CO2) in the blood, resulting in respiratory acidosis. This condition is characterized by a decrease in blood pH due to the accumulation of CO2, which forms carbonic acid. Hypoventilation does not cause metabolic acidosis, as it primarily affects the respiratory component of acid-base balance.

Choice B: Massive Blood Transfusion

Massive blood transfusion can lead to metabolic alkalosis rather than metabolic acidosis. This is because stored blood products often contain citrate, which is metabolized to bicarbonate in the liver, increasing the blood’s alkalinity. Additionally, the transfusion of large volumes of blood can dilute the plasma bicarbonate concentration, but this typically does not result in metabolic acidosis.

Choice C: Kidney Failure

Kidney failure is a common cause of metabolic acidosis. The kidneys play a crucial role in maintaining acid-base balance by excreting hydrogen ions (H+) and reabsorbing bicarbonate (HCO3-). When the kidneys fail, they are unable to remove sufficient acids from the blood, leading to an accumulation of metabolic acids and a decrease in blood pH. This condition is known as metabolic acidosis and can result from chronic kidney disease (CKD) or acute kidney injury (AKI).

Choice D: Hyperventilation

Hyperventilation leads to respiratory alkalosis, not metabolic acidosis. This condition occurs when there is excessive ventilation, causing a decrease in CO2 levels in the blood and an increase in blood pH. Hyperventilation reduces the concentration of carbonic acid, leading to an alkaline state. It does not contribute to metabolic acidosis, which involves an imbalance in the metabolic components of acid-base regulation.

Choice A Reason:

Bronchoconstriction is the narrowing of the airways in the lungs due to the tightening of surrounding smooth muscle. This response is typically associated with conditions like asthma and is not a common reaction to acute stress. During stress, the sympathetic nervous system actually causes bronchodilation to increase airflow and oxygen delivery to the muscles.

Choice B Reason:

This is the correct answer. Increased glucose production is a typical response to acute stress. The body releases stress hormones like adrenaline and cortisol, which stimulate the liver to produce more glucose. This process, known as glycogenolysis, ensures that the body has enough energy to handle the stressor. This response is part of the “fight-or-flight” mechanism, preparing the body for immediate physical activity.

Choice C Reason:

Decreased cortisol release is not expected during acute stress. In fact, cortisol levels typically increase as part of the body’s stress response. Cortisol helps to mobilize energy stores, suppress inflammation, and support cardiovascular function. Therefore, this choice is incorrect.

Choice D Reason:

Bradycardia, or a slower than normal heart rate, is not a typical response to acute stress. Instead, the sympathetic nervous system increases heart rate (tachycardia) to ensure that more blood is pumped to vital organs and muscles. This helps the body to respond more effectively to the stressor.