Final answer:
The nurse should monitor the client for respiratory acidosis, which occurs when there is excessive retention of CO2 due to impaired pulmonary function as seen in COPD with pneumonia, resulting in a decrease in blood pH and hypercapnia. The correct answer is option b. respiratory acidosis.
Step-by-step explanation:
The nurse should monitor the client for respiratory acidosis. Chronic obstructive pulmonary disease (COPD) with pneumonia can impair the ability to exhale CO2, leading to an accumulation of carbonic acid in the blood. This situation can result in an acid-base imbalance known as respiratory acidosis, characterized by a decrease in blood pH and elevated pCO2 levels.
Monitoring would involve assessing the patient's respiratory status and blood gas measurements, such as pH and pCO2. When the lungs are unable to remove all of the carbon dioxide produced by the body, it accumulates in the bloodstream causing hypercapnia. Pneumonia exacerbates this problem by further reducing lung function.
Reviewing the case study of the 64-year-old patient admitted with asthma and abnormal laboratory results, we can classify the acid-base balance. With a pH of 7.31, indicating acidosis (normal pH range is 7.35-7.45), a pCO2 higher than normal, and total HCO3- also higher than normal, the patient's results are indicative of respiratory acidosis with metabolic compensation.
The high pCO2 points to a respiratory problem, and the increased bicarbonate suggests that the kidneys are working to compensate. The mechanism by which asthma contributed to these results is through bronchoconstriction and airway inflammation, leading to inadequate ventilation and CO2 retention.