The nurse provides care for several clients. Which client is most at risk to develop metabolic acidosis?

Choice A reason: Hemothorax is not the correct explanation because it is a condition where blood accumulates in the pleural space, which is the area between the lungs and the chest wall. Hemothorax can cause low blood pressure, rapid breathing, and reduced breath sounds, but it does not cause tracheal deviation, which is a sign of increased pressure in the chest.

Choice B reason: Absorption atelectasis is not the correct explanation because it is a condition where the alveoli, which are the tiny air sacs in the lungs, collapse due to lack of oxygen. Absorption atelectasis can cause reduced breath sounds, but it does not cause low blood pressure, rapid breathing, or tracheal deviation, which are signs of a life-threatening emergency.

Choice C reason: Tension pneumothorax is the correct explanation because it is a condition where air leaks into the pleural space and creates a one-way valve that prevents the air from escaping. This causes the pressure in the chest to increase, which compresses the lung, the heart, and the great vessels. Tension pneumothorax can cause low blood pressure, rapid breathing, absent breath sounds, and tracheal deviation, which are signs of a medical emergency that requires immediate treatment.

Choice D reason: Hypovolemic shock is not the correct explanation because it is a condition where the body loses a large amount of blood or fluid, which reduces the blood volume and the blood pressure. Hypovolemic shock can cause low blood pressure and rapid breathing, but it does not cause absent breath sounds or tracheal deviation, which are signs of a chest injury.

Choice A reason: Decreased skin turgor is not the most common clinical manifestation of nephrotic syndrome because it is a sign of dehydration, not nephrotic syndrome. Dehydration is a condition where the body loses more fluid than it takes in, which can cause the skin to lose its elasticity and firmness. Dehydration can be caused by various factors, such as vomiting, diarrhea, fever, or excessive sweating.

Choice B reason: Hypoalbuminemia is the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a low level of albumin, which is a protein that helps maintain the fluid balance in the body. Nephrotic syndrome is a kidney disorder that causes the kidneys to leak large amounts of protein into the urine, which reduces the amount of protein in the blood. Albumin is the most abundant protein in the blood, and it helps to keep the fluid in the blood vessels, preventing it from leaking into the tissues. When the albumin level is low, the fluid can escape from the blood vessels and cause edema, which is swelling of the body parts.

Choice C reason: Decreased serum cholesterol is not the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a low level of cholesterol, which is a type of fat that is needed for the synthesis of hormones, bile acids, and cell membranes. Decreased serum cholesterol is not a common finding in nephrotic syndrome, because the liver tends to produce more cholesterol to compensate for the loss of protein in the urine. This can lead to hypercholesterolemia, which is a condition where the blood has a high level of cholesterol, which can increase the risk of cardiovascular diseases.

Choice D reason: Increased serum sodium is not the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a high level of sodium, which is an electrolyte that helps regulate the fluid and acid-base balance in the body. Increased serum sodium is not a common finding in nephrotic syndrome, because the kidneys tend to excrete more sodium in the urine to balance the fluid loss caused by hypoalbuminemia. This can lead to hyponatremia, which is a condition where the blood has a low level of sodium, which can cause symptoms such as confusion, weakness, seizures, and coma.