The nurse is caring for a newborn requiring a life-saving blood transfusion. The parents are practicing Jehovah’s Witnesses and refuse the transfusion. Who would the nurse consult for assistance in this situation?

Choice A reason: Encouraging the patient to drink more fluids is a primary intervention for managing thick respiratory secretions. Adequate hydration helps to thin the mucus, making it easier to expectorate. Fluids such as water, herbal teas, and clear broths are particularly effective. The normal daily fluid intake for an adult is about 2-3 liters, depending on individual needs and health conditions.

Choice B reason: Getting a prescription for an antitussive agent is not the best initial approach for managing thick respiratory secretions. Antitussive agents are used to suppress coughing, which can be counterproductive when trying to clear mucus from the respiratory tract. Instead, expectorants or mucolytics are more appropriate as they help to thin and loosen the mucus.

Choice C reason: Teaching effective deep breathing is beneficial for overall lung health and can help in mobilizing secretions. However, it is not as immediately effective as increasing fluid intake for thinning thick secretions. Deep breathing exercises can be part of a comprehensive respiratory care plan but should be combined with other interventions like hydration.

Choice D reason: Changing the patient’s position every 2 hours is a good practice for preventing complications such as pressure ulcers and promoting lung expansion. However, it is not specifically targeted at thinning thick respiratory secretions. Positional changes can aid in the drainage of secretions but are secondary to ensuring adequate hydration.

Choice A Reason:

Metabolic Alkalosis is correct. The pH of 7.56 is above the normal range (7.35-7.45), indicating alkalosis. The HCO3 level of 33 mEq/L is also above the normal range (22-28 mEq/L), which suggests a metabolic cause. In metabolic alkalosis, the body has an excess of bicarbonate or a loss of hydrogen ions.

Choice B Reason:

Metabolic Acidosis is incorrect. Metabolic acidosis is characterized by a low pH (below 7.35) and a low HCO3 level (below 22 mEq/L). The given values indicate alkalosis, not acidosis.

Choice C Reason:

Respiratory Alkalosis is incorrect. Respiratory alkalosis is characterized by a high pH (above 7.45) and a low PaCO2 (below 35 mmHg). In this case, the PaCO2 is elevated (55 mmHg), which does not align with respiratory alkalosis.

Choice D Reason:

Respiratory Acidosis is incorrect. Respiratory acidosis is characterized by a low pH (below 7.35) and a high PaCO2 (above 45 mmHg). While the PaCO2 is elevated, the pH indicates alkalosis, not acidosis.