A nurse is assessing a client who has respiratory acidosis. Which of the following findings should the nurse expect?

Choice A rationale Respiratory acidosis occurs when there is an accumulation of carbon dioxide (CO2) due to hypoventilation, leading to a decrease in blood pH. Increased levels of CO2 act as a potent vasodilator in the brain and a central nervous system depressant. This leads to manifestations such as lethargy, confusion, somnolence, and eventually coma if not treated. The nurse should prioritize assessing the client's level of consciousness and mental status, as these are the earliest and most common signs of hypercapnia. Choice B rationale Abdominal pain is not a classic finding associated with respiratory acidosis. Abdominal symptoms are more frequently seen in metabolic acidosis, specifically diabetic ketoacidosis (DKA), where gastrointestinal upset and pain result from the metabolic derangement and ketone production. Respiratory acidosis primarily manifests through neurological and cardiovascular changes due to the direct effect of elevated carbon dioxide on the blood vessels and brain tissue. Therefore, the nurse would focus on respiratory and neurological assessments rather than the abdomen. Choice C rationale Clients with respiratory acidosis often exhibit skin changes, but they are typically characterized by vasodilation. This makes the skin appear warm, flushed, and moist rather than dry. Dry skin and mucous membranes are more indicative of dehydration or fluid volume deficit. Because the elevated CO2 levels cause peripheral vessels to dilate in an attempt to manage the acid-base imbalance, the nurse should expect the client to feel warm to the touch and possibly show signs of diaphoresis. Choice D rationale Numbness and tingling of the fingers, known as paresthesia, is a hallmark sign of alkalosis, not acidosis. In alkalosis, the increased pH causes a decrease in ionized calcium, which increases neuromuscular irritability and leads to tingling sensations. In respiratory acidosis, the effect on the nervous system is depressive. Instead of increased excitability, the nurse would observe signs of decreased nerve conduction and muscle weakness, as the acidic environment inhibits the normal electrical activity of nerves and muscles. .