A nurse is about to administer a bolus enteral feeding to a client who is on bedrest. How does the nurse position the client during the feeding?

A. Metabolic alkalosis is characterized by an elevation of the bicarbonate (HCO3) levels in the blood, leading to an increase in pH above the normal range (7.35-7.45). Antacid tablets typically contain compounds such as calcium carbonate, magnesium hydroxide, or aluminum hydroxide, which can neutralize stomach acid (hydrochloric acid). Chronic ingestion of large amounts of antacids, as in the case of this client taking approximately 15 tablets per day, can result in excessive bicarbonate intake, leading to metabolic alkalosis.
B. Respiratory alkalosis occurs when there is a decrease in carbon dioxide (CO2) levels in the blood, leading to an increase in pH above the normal range. Antacid tablets do not directly affect respiratory function or CO2 levels, so respiratory alkalosis is unlikely to occur as a result of antacid ingestion.
C. Metabolic acidosis is characterized by a decrease in bicarbonate (HCO3) levels in the blood, leading to a decrease in pH below the normal range. In the context of antacid ingestion, metabolic acidosis is less likely to occur. However, if the antacids contain compounds that are absorbed systemically and excreted by the kidneys (such as aluminum-containing antacids), they may lead to renal dysfunction or electrolyte imbalances, which could potentially contribute to metabolic acidosis.
D. Respiratory acidosis occurs when there is an increase in carbon dioxide (CO2) levels in the blood, leading to a decrease in pH below the normal range. Antacid tablets do not directly affect respiratory function or CO2 levels, so respiratory acidosis is unlikely to occur as a result of antacid ingestion.

A. Gradual tapering of benzodiazepines under medical supervision is recommended to minimize withdrawal symptoms and rebound insomnia. The client should continue taking the medication as prescribed while discussing a tapering plan with their physician.
B. Abruptly stopping benzodiazepines can lead to withdrawal symptoms, including rebound insomnia, anxiety, agitation, and even seizures. Planning to stop medication on a specific day without medical guidance can increase the risk of withdrawal symptoms occurring during the workweek.

C. While it may be challenging to sleep without benzodiazepines initially, continued use can lead to dependence and tolerance, making it even more challenging to discontinue them in the future. Gradual tapering under medical supervision is the preferred approach.
D. Antihistamines are not typically used as substitutes for benzodiazepines in managing insomnia. Additionally, abruptly stopping benzodiazepines and switching to another medication without medical guidance can lead to withdrawal symptoms and inadequate management of insomnia.