History of chronic bronchitis

J.D., an 83-year-old Caucasian male client in the hospital, has been diagnosed with pneumonia. The client has a history of chronic bronchitis and had a thoracotomy 2 weeks ago. He lives in a home infested with cockroaches. At his most recent visit to the health center, his ABGs come back as:

pH = 7.31, pCO2 = 49, and HCO3 = 23.

• What do you know about J.D. without receiving any further information?
• What further information would you need to care for J.D.?
• What are the initial interventions you would use for J.D.?
• What are your top two priority interventions at this point in his care?
• What teachings should you provide for J.D.?
• What are safety considerations for this client?
• What specific type of acid-base imbalance does this client have?
• What is the most probable origin of the acid-base imbalance?
• What treatments would you anticipate providing for this client? Why?