The nurse is caring for a client diagnosed with acute respiratory failure as a result of right middle and lower lobe pneumonia. To optimize ventilation and secretion removal the nurse should position the client:

A. This is a safe medication that is associated with minimal side effects: Carbidopa/levodopa is an effective medication for managing the symptoms of Parkinson's disease, but it is not without side effects. Common side effects include nausea, dizziness, dyskinesia (involuntary movements), and orthostatic hypotension. It is important to be honest with clients about the potential side effects and manage them proactively, rather than describing the medication as "safe with minimal side effects," which could lead to underestimating the risks.

B. Stop the medication if there is increased urination: Increased urination is not a common or typical side effect of carbidopa/levodopa. In fact, the medication is more likely to cause urinary retention or difficulty urinating in some cases. The client should not stop taking the medication without consulting their healthcare provider. Any urinary changes should be reported, but abrupt discontinuation of the medication is not advised without medical supervision.

C. Change position slowly to prevent orthostatic hypotension: One of the common side effects of carbidopa/levodopa therapy is orthostatic hypotension, which occurs when a person experiences a drop in blood pressure upon standing up. This can lead to dizziness or fainting, increasing the risk of falls. The client should be educated to change positions slowly, such as sitting up slowly and standing up gradually from a lying position, to minimize the risk of orthostatic hypotension. This is a critical aspect of safety and should be emphasized as part of the teaching.

D. Double the dose if a dose is missed at the next scheduled time: Doubling the dose of carbidopa/levodopa if a dose is missed can lead to an overdose, which may cause serious side effects, including dyskinesias or other complications. Clients should be instructed to take the missed dose as soon as they remember, unless it is almost time for the next dose. In that case, they should skip the missed dose and continue with their regular dosing schedule. It is important to never double the dose without guidance from the healthcare provider.

A. Notify the healthcare provider: While notifying the healthcare provider may eventually be necessary, the first priority is to ensure the client's airway is protected and they are receiving adequate ventilation. The provider can be notified after immediate interventions have been made to stabilize the patient.

B. Insert an oral airway to prevent the client from biting the tube: Inserting an oral airway may be necessary if the client is biting the endotracheal tube, but this is unlikely the first action needed in response to a low-pressure alarm. If the client is not biting the tube, this action will not address the potential causes of the low-pressure alarm, such as a disconnection, leak, or circuit issue.

C. Suction the client and reset the alarm: While suctioning is an important intervention if secretions are the cause of ventilation issues, it is not the first action when the source of the low-pressure alarm is unclear. If a disconnection or leak is the issue, suctioning will not resolve the problem, and the nurse risks delaying appropriate action to address the source of the alarm. The priority is ensuring the client’s ventilation is not compromised, which is best accomplished by using a manual resuscitation bag until the problem is identified and corrected.

D. Disconnect the client from the ventilator and use a manual resuscitation bag: If the source of the low-pressure alarm cannot be identified after checking the client and the ventilator, the first priority is to ensure that the client continues to receive adequate ventilation. Disconnecting the client from the ventilator and using a manual resuscitation bag (Ambu bag) allows for immediate support of the patient's ventilation while the nurse investigates the cause of the alarm. This ensures the client's oxygenation and ventilation needs are met until the problem is resolved. It is critical to address any potential loss of positive pressure or leaks in the ventilator system promptly to avoid respiratory distress or failure.