A nurse in an emergency department is admitting a client who has overdosed on antacids and is in a state of metabolic alkalosis. For which of the following manifestations should the nurse monitor?
Diarrhea
Bradycardia
Tinnitus
Tetany
The Correct Answer is D
A) Diarrhea: Metabolic alkalosis is more likely to be associated with constipation rather than diarrhea. Diarrhea is typically a cause of metabolic acidosis due to the loss of bicarbonate in stool, rather than a result of metabolic alkalosis.
B) Bradycardia: Bradycardia is not a typical manifestation of metabolic alkalosis. Alkalosis can lead to arrhythmias, but it generally does not cause a slow heart rate. Instead, tachycardia might occur as the body compensates for the altered acid-base balance.
C) Tinnitus: Tinnitus is not a common symptom of metabolic alkalosis. It is more often associated with aspirin toxicity or other conditions affecting the auditory system, rather than changes in acid-base balance.
D) Tetany: Tetany is a common manifestation of metabolic alkalosis. The alkalosis causes a decrease in ionized calcium levels, which increases neuromuscular excitability and can lead to muscle cramps, spasms, and tetany. This is a key sign for nurses to monitor as it indicates significant electrolyte disturbances associated with the alkalotic state.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B,C,E,A,D
Explanation
B. Attach the spacer.: Attaching the spacer first ensures that the inhaler is properly connected and ready for use.
C. Shake the inhaler.: Shaking the inhaler is essential to mix the medication thoroughly before use.
E. Place lips around the mouthpiece.: Placing the lips around the mouthpiece is done while the inhaler is ready to be activated.
A. Press down on the canister top.: Pressing the canister releases the medication into the spacer, which the client will then inhale.
D. Hold breath for 10 seconds.: Holding the breath allows the medication to be fully absorbed into the lungs.
Correct Answer is B
Explanation
A) "Sit with your legs in a dependent position when in a chair."
Sitting with legs in a dependent position can decrease blood flow and increase the risk of clot formation. It's important to elevate the legs when sitting to promote venous return and reduce the risk of deep-vein thrombosis (DVT).
B) "Prevent dehydration by drinking at least 2.5 liters fluids each day."
Staying well-hydrated helps maintain good blood circulation and prevents blood from becoming too viscous, reducing the risk of clot formation. Adequate fluid intake is crucial in preventing DVT.
C) "Massage your calves after sitting for 2 hours."
Massaging the calves is not recommended for someone with a history of DVT, as it may dislodge a clot. Instead, clients should be encouraged to move or stretch their legs regularly to improve circulation.
D) "Roll stretchy nylon stockings down to the upper part of your calves."
Proper use of compression stockings involves wearing them as prescribed, which typically means keeping them fully extended to ensure consistent pressure along the leg. Rolling them down can create a tourniquet effect and is not recommended.
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