A client is admitted with renal calculi. The client is panting in pain and vomiting. Arterial blood gases are: PH 7.54 Pa02 78 mm Hg PC02 26 mm Hg PC02 26 mm Hg HC03 25 mEq/L What is the priority nursing action?

A. Administer an antiemetic: Vomiting contributes to fluid and electrolyte loss, which can exacerbate alkalosis, but while antiemetics are important, they do not directly address the immediate physiologic derangement causing distress. B. Administer pain medication: The client’s ABG shows a pH of 7.54 and PaCO2 of 26 mm Hg, consistent with respiratory alkalosis. The primary cause is hyperventilation driven by severe pain and distress from renal calculi. Administering analgesia will reduce pain-induced hyperventilation, normalize the respiratory rate, and help correct the acid-base imbalance. C. Prepare for intubation: Intubation is indicated for severe respiratory failure or inability to maintain oxygenation/ventilation. The PaO2 is mildly decreased at 78 mm Hg, and the client is hyperventilating but still maintaining ventilation, so immediate intubation is not warranted. D. Administer a bronchodilator: Bronchodilators are used to relieve bronchospasm and airflow obstruction, which is not the cause of this client’s hyperventilation. They would not correct respiratory alkalosis driven by pain.