The nurse is caring for a client that was admitted with nausea/vomiting, restlessness, dry oral mucosa, and extreme thirst. The nurse understands that the client has which electrolyte imbalance?

A. Prolongs expiration to reduce airway resistance: Pursed-lip breathing is a technique that slows exhalation, creating back pressure in the airways. This helps prevent airway collapse, particularly in patients with obstructive pulmonary conditions such as COPD, improves alveolar ventilation, enhances gas exchange, and reduces dyspnea. Prolonged expiration also helps decrease air trapping and promotes more effective ventilation.

B. Reduces the need for PRN pain medications: Pursed-lip breathing is not intended to control pain. While relaxation and improved oxygenation may reduce anxiety or discomfort related to dyspnea, it does not have a direct analgesic effect or replace prescribed pain management strategies.

C. Uses upper chest muscles more effectively: The technique primarily focuses on controlled diaphragmatic and lip-controlled exhalation rather than emphasizing upper chest muscle activity. Overusing upper chest muscles can increase fatigue and is not the goal of this breathing technique.

D. Replaces the use of incentive spirometry: Pursed-lip breathing does not serve the same purpose as incentive spirometry, which promotes deep inhalation to prevent atelectasis. While both improve pulmonary function, pursed-lip breathing specifically targets exhalation and airway patency, not inspiratory lung expansion.

A. Anxious client awaiting a procedure reporting new onset of chest pressure: New chest pressure in a client can indicate acute myocardial ischemia or another life-threatening cardiac event. Immediate assessment and intervention are critical to ensure patient safety, making this the highest-priority client. Prompt recognition of potential cardiac compromise is essential to prevent deterioration.

B. Angry client dissatisfied with the room and demands to speak to the unit director: While addressing patient concerns and complaints is important for patient satisfaction and communication, this situation is non-urgent and does not pose an immediate threat to the client’s physiological stability.

C. Status post-surgical client complaining of pain 4/10 at a large incision site: Moderate pain requires timely management to promote comfort and recovery; however, it does not indicate an immediate life-threatening condition. Pain management is important but secondary to acute chest pain.

D. Client admitted with a bowel obstruction who has nausea and vomiting: Nausea and vomiting need assessment and intervention to prevent complications such as dehydration, but unless accompanied by signs of hemodynamic instability or electrolyte imbalance, this is less urgent than acute chest pain signaling potential cardiac compromise.