Select all of the factors that may predispose the patient to respiratory acidosis. Select all that apply.

Anxiety and fear

Central nervous system depression

Diabetic ketoacidosis

Nasogastric suctioning

Overdose of sedatives

Answer and Explanation

Correct Answer : B,E

Rationale:

A. Anxiety and fear usually increase respiratory rate and depth (hyperventilation). Hyperventilation blows off CO2, which can lead to respiratory alkalosis, not acidosis. Therefore, anxiety is not a predisposing factor for respiratory acidosis.

B. CNS depression from conditions such as stroke, brain injury, sedation, or neurologic disease can suppress the respiratory drive, leading to hypoventilation. Hypoventilation results in CO2 retention, which increases PaCO2 and lowers pH, producing respiratory acidosis.

C. DKA causes metabolic acidosis due to the accumulation of ketone bodies. The patient often develops Kussmaul respirations (deep, rapid breathing) to blow off CO2 as a compensatory mechanism, which is opposite of respiratory acidosis.

D. NG suctioning removes gastric acid, which can lead to loss of hydrogen ions, causing metabolic alkalosis, not respiratory acidosis. It does not directly affect CO2 elimination or the respiratory system.

E. Sedatives such as benzodiazepines, opioids, or barbiturates depress the CNS, including the respiratory centers in the medulla. This leads to hypoventilation, decreased alveolar ventilation, and CO2 retention, resulting in respiratory acidosis.

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Correct Answer is C

Explanation

A. This is incorrect

B. This is incorrect

C. Step 1: Use the formula
Flow rate (mL/hr) = Total volume ÷ Time in hours

Step 2: Convert minutes to hours
30 minutes = 0.5 hour

Step 3: Insert known values
Total volume = 100 mL
Time = 0.5 hr

Flow rate = 100 ÷ 0.5
Flow rate = 200 mL/hr

Step 4: Match to the options
200 mL/hr

Final Answer: C. 200 mL/hr

D. This is incorrect

A. Beans B. Milk C. Peas D. Coffee

Correct Answer is D

Explanation

Rationale:

A. Beans are a safe source of protein, fiber, and other nutrients and do not interfere with the absorption, metabolism, or excretion of theophylline. Including beans in the diet will not affect the drug’s therapeutic levels or increase the risk of toxicity. Therefore, there is no need to omit beans from the client’s meal tray.

B. Milk and other dairy products are also safe for clients taking theophylline. Calcium in milk does not impact the pharmacokinetics of theophylline or reduce its effectiveness. The client can safely consume milk as part of their regular diet without concern for interactions with the medication.

C. Peas are another safe and nutritious food that has no known interaction with theophylline. They provide vitamins, minerals, and fiber but do not affect drug levels or the risk of side effects. Including peas on the meal tray is appropriate and does not pose a safety concern.

D. Coffee contains caffeine, which belongs to the same pharmacologic class as theophylline, called methylxanthines. Consuming caffeine while taking theophylline can lead to additive stimulant effects, increasing central nervous system stimulation and causing restlessness, insomnia, or anxiety. It can also increase cardiac stimulation, leading to tachycardia, palpitations, and potentially dangerous arrhythmias. Additionally, caffeine may exacerbate gastrointestinal side effects such as nausea, vomiting, or abdominal discomfort. Because caffeine can potentiate theophylline toxicity even when the medication is at therapeutic levels, it is essential to avoid coffee and other caffeinated products, including tea, chocolate, energy drinks, and some sodas. The nurse should educate the client about reading labels and monitoring their total caffeine intake to ensure safe theophylline therapy.

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Select all of the factors that may predispose the patient to respiratory acidosis. Select all that apply.

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Correct Answer is D

Explanation

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