The nurse is caring for a patient, newly diagnosed with chronic obstructive pulmonary disease (COPD), who has an order for a budesonide inhaler. When planning medication teaching, the nurse will plan to include which potential side effects of this medication? (Select All That Apply)

Choice A reason: An arterial pH less than 7.3 indicates acidosis, which is common in diabetic ketoacidosis but not typical in hyperglycemic hyperosmolar syndrome. Patients with hyperglycemic hyperosmolar syndrome typically have a near-normal pH.

Choice B reason: Altered mental status is a significant clinical manifestation in hyperglycemic hyperosmolar syndrome due to severe hyperglycemia and the hyperosmolar state, which can lead to dehydration and impaired brain function.

Choice C reason: The presence of ketones in urine is more commonly associated with diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome. The absence of significant ketonemia differentiates hyperglycemic hyperosmolar syndrome from diabetic ketoacidosis.

Choice D reason: Serum bicarbonate less than 15 mEq/L is indicative of metabolic acidosis, typically seen in diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome, where bicarbonate levels are usually normal or slightly decreased.

Choice A reason: White milky liquid stools immediately after a barium enema are not uncommon and are typically due to the passage of barium. This finding does not usually require immediate reporting unless there are other concerning symptoms.

Choice B reason: Not having a bowel movement for three days in a patient with irritable bowel syndrome (IBS) can be uncomfortable but is not typically an emergency. Management can be addressed through dietary and medication adjustments rather than immediate reporting.

Choice C reason: A temperature of 101°F and abdominal distention in a patient diagnosed with ulcerative colitis is concerning and should be reported immediately. These symptoms can indicate a serious complication such as toxic megacolon, perforation, or severe infection, which require prompt medical intervention.

Choice D reason: A blood glucose level of 225 mg/dL in a patient receiving Total Parenteral Nutrition (TPN) is elevated but not necessarily an emergency. Elevated blood glucose levels are a common side effect of TPN and can be managed through adjustments in insulin or TPN composition.