A nurse is planning care for a client who is anxious and irritable. The client's arterial blood gas values are pH 7.30, PaO2 96 mm Hg, PaCO2 43 mm Hg, and HCO3- 19 mEq/L. Which questions should the nurse ask the client and spouse when developing the plan
a. "Are you taking any antacid medications?"
b. "Is your spouse's current behavior typical?"
c. "Do you drink any alcoholic beverages?"
d. "Have you been experiencing any vomiting?"
e. "Are you experiencing any shortness of breath?"
ANS: B, C
This client's symptoms of anxiety and irritability are related to a state of metabolic acidosis. The nurse should ask the client's spouse or family members if the client's behavior is typical for him or her, and establish a baseline for comparison with later assessment findings. The nurse should also assess for alcohol intake because alcohol can change a client's personality and cause metabolic acidosis. The other options are not causes of metabolic acidosis.
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