Colleen, a 19 year old Freshman, was drinking alcohol at a frat party. She stupors, falls and hits her head on the ground. Her friend Julie dials "911" because Colleen is now unconscious, depressed ventilation (shallow and slow respirations), rapid heart rate, and is profusely bleeding from both ears. Which primary acid-base imbalance is Colleen at risk for if medical attention is not provided?

The teaching that the nurse will provide to the Patient Care Technician (PCT) when delegating ambulation for a client includes:

● "Please let me know how the client does after each ambulation": This instruction ensures that the PCT communicates any relevant information or changes observed during or after the ambulation, allowing the nurse to stay informed about the client's condition.

● "Be certain to use a gait belt when performing this activity": Using a gait belt is an important safety measure during ambulation. It helps provide support and stability for the client and allows the PCT to maintain control and assist in case the client becomes unsteady or falls.

● "Each ambulation should last 10 minutes": Providing a specific time frame for the ambulation helps guide the PCT in determining the duration of the activity. This ensures consistency in the care provided and allows for proper scheduling of ambulation throughout the day.

The other options provided ("Ambulate the client every four hours," "Come and get me for lunch") do not pertain to specific instructions or teaching related to the delegated ambulation task. The frequency of ambulation and the PCT's lunch break are not relevant to the teaching for this specific task.

Respiratory acidosis is a primary acid-base imbalance that occurs when there is an excess of carbon dioxide (CO2) in the body due to impaired ventilation or inadequate removal of CO2 from the lungs. In this case, Colleen's depressed ventilation, indicated by shallow and slow respirations, can lead to inadequate elimination of CO2 from her body. The excessive CO2 levels can result in an accumulation of carbonic acid (H2CO3) in the blood, leading to an increase in acidity and a decrease in pH.

The profuse bleeding from both ears indicates a potential head injury, which can lead to decreased neurological function and impaired control over the respiratory center in the brain. This can further contribute to depressed ventilation and the development of respiratory acidosis. Metabolic acidosis, characterized by a decrease in bicarbonate (HCO3-) levels or an increase in non-carbonic acids in the blood, is not the primary acid-base imbalance in this case since the scenario does not provide information indicating a primary metabolic disorder. Respiratory alkalosis, characterized by decreased levels of CO2 in the blood, leading to increased pH and alkalinity, is not the primary acid-base imbalance in this case. The depressed ventilation and associated increase in CO2 levels indicate the opposite, respiratory acidosis. Metabolic alkalosis, characterized by an increase in bicarbonate levels or a decrease in non-carbonic acids, is not the primary acid-base imbalance in this case as the scenario does not provide information indicating a primary metabolic disorder.