A person with a blood pH of 7.21 is considered to have which of the following?

Choice A reason:

Potassium (K+) level of 5.6 mEq/L is a critical finding that requires immediate follow-up. Hyperkalemia, defined as a potassium level greater than 5.0 mEq/L, can lead to severe cardiac complications, including arrhythmias and cardiac arrest. The patient’s ECG changes, such as alterations in the T wave and PR interval, indicate that the elevated potassium level is already affecting cardiac function. Immediate intervention is necessary to lower the potassium level and prevent life-threatening complications. Normal potassium levels range from 3.5 to 5.0 mEq/L.

Choice B reason:

BP 109/70 is slightly lower than the normal range but not critically low. While it is important to monitor blood pressure, this finding does not require immediate follow-up compared to the other more critical issues. The patient’s blood pressure should be monitored regularly to ensure it does not drop further, but it is not the most urgent concern at this moment. Normal blood pressure is typically around 120/80 mmHg.

Choice C reason:

No nausea and vomiting is a positive finding indicating that the patient is not losing additional fluids and electrolytes through emesis. While it is important to note, it does not require follow-up as it does not pose an immediate risk to the patient’s health. The absence of nausea and vomiting is beneficial but does not address the primary concerns related to fluid and electrolyte imbalances.

Choice D reason:

Watery diarrhea for 3 days is a significant finding that requires follow-up due to the risk of dehydration and electrolyte imbalances. Diarrhea leads to the loss of fluids and essential electrolytes, which can result in complications such as hypovolemia and electrolyte disturbances. The patient’s ongoing diarrhea needs to be managed to prevent further fluid loss and stabilize their condition. This symptom is directly contributing to the patient’s current state of weakness and electrolyte imbalance.

Choice E reason:

Lightheaded when standing up suggests orthostatic hypotension, which can be a result of dehydration or electrolyte imbalances. This symptom indicates that the patient is experiencing hemodynamic instability, likely due to fluid loss from diarrhea. It is important to address this issue to prevent falls and further complications. Managing the underlying cause, such as rehydration and correcting electrolyte imbalances, will help stabilize the patient’s condition.

Choice F reason:

Blood Urea Nitrogen (BUN) level of 30 mg/dL is elevated, indicating impaired kidney function or dehydration. Normal BUN levels range from 6 to 24 mg/dL. An elevated BUN level suggests that the kidneys are struggling to manage the body’s waste products and fluid balance. This finding is critical for understanding the extent of the patient’s fluid and electrolyte imbalances and guiding appropriate interventions. Addressing the elevated BUN is essential for improving renal function and overall patient health.

Choice G reason:

HR 102 is slightly elevated, indicating tachycardia. Normal heart rate ranges from 60 to 100 beats per minute. Tachycardia can be a sign of dehydration, pain, anxiety, or other underlying conditions. In this case, the elevated heart rate is likely related to the patient’s dehydration and electrolyte imbalances. Monitoring and managing the heart rate is important to ensure the patient’s cardiovascular stability. Interventions to correct fluid and electrolyte imbalances will help normalize the heart rate.

Choice H reason:

Lung sounds are clear is an important assessment finding but does not require follow-up in the context of fluid and electrolyte imbalances. Clear lung sounds indicate that the patient is not experiencing respiratory complications such as pulmonary edema or infection. While this is a positive finding, it does not address the immediate concerns related to the patient’s fluid and electrolyte status.

Choice A reason:

Offering peppermint aromatherapy during and after chemotherapy can be an effective non-pharmacological intervention for managing chemotherapy-induced nausea and vomiting (CINV). Aromatherapy with peppermint oil has been shown to reduce nausea and improve comfort in patients undergoing chemotherapy. The scent of peppermint can have a calming effect on the gastrointestinal system, helping to alleviate nausea. This intervention is easy to implement and can be used alongside other treatments to enhance patient comfort.

Choice B reason:

Administering antiemetics before chemotherapy is a standard practice for preventing CINV. Antiemetics, such as 5-HT3 receptor antagonists (e.g., ondansetron), NK1 receptor antagonists (e.g., aprepitant), and corticosteroids (e.g., dexamethasone), are commonly used to prevent nausea and vomiting associated with chemotherapy. These medications are most effective when given prophylactically, before the onset of symptoms. Administering antiemetics before chemotherapy helps to block the pathways that trigger nausea and vomiting, providing better control over these symptoms.

Choice C reason:

Keeping Ms. Anderson NPO (nothing by mouth) for the duration of the chemotherapy is not recommended for managing CINV. Keeping patients NPO can lead to dehydration and malnutrition, which can worsen their overall condition. Instead, patients should be encouraged to eat small, frequent meals and stay hydrated to maintain their strength and well-being. Proper nutrition and hydration are essential for supporting the body’s ability to tolerate chemotherapy and recover from its side effects.

Choice D reason:

Encouraging the patient to eat and drink when not nauseated is an important strategy for managing CINV. Eating small, frequent meals and staying hydrated can help maintain energy levels and prevent dehydration. Patients should be advised to eat bland, easy-to-digest foods and avoid foods that are greasy, spicy, or have strong odors, as these can exacerbate nausea. Encouraging patients to eat and drink when they feel well can help them maintain their nutritional status and improve their overall tolerance to chemotherapy.

Choice E reason:

Offering small sips of ginger ale can help manage nausea. Ginger has natural antiemetic properties and can be effective in reducing nausea and vomiting. Ginger ale, ginger tea, or ginger candies can be soothing and help settle the stomach. This simple intervention can be easily incorporated into the patient’s routine and can provide relief from mild to moderate nausea.

Choice F reason:

Encouraging Ms. Anderson to eat a high-protein meal prior to the chemotherapy infusion is not typically recommended for managing CINV. High-protein meals can be harder to digest and may increase the risk of nausea. Instead, patients should be advised to eat light, bland meals before chemotherapy to minimize the risk of nausea and vomiting. Light meals are easier on the stomach and less likely to trigger gastrointestinal discomfort.