A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?
Place the client on seizure precautions.
Have the client breath into a paper bag.
Encourage the client to breath slowly,
Plan to administer sodium bicarbonate to the client
The Correct Answer is A
A. Placing the client on seizure precautions is important as metabolic alkalosis can cause neurological symptoms, such as confusion and increased risk for seizures due to electrolyte imbalances (e.g., low calcium levels). Therefore, seizure precautions are warranted.
B. Breathing into a paper bag is used in respiratory alkalosis to increase CO2 levels, but it is not appropriate in metabolic alkalosis, where the issue is not primarily related to CO2 imbalance.
C. Encouraging the client to breathe slowly is generally more appropriate for respiratory alkalosis, not metabolic alkalosis. Slow breathing would not directly address the underlying issue of metabolic alkalosis.
D. Administering sodium bicarbonate would worsen metabolic alkalosis, as it would further increase the alkalotic state. Sodium bicarbonate is used in metabolic acidosis, not alkalosis.
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Related Questions
Correct Answer is B
Explanation
A. Having the client place their head between their knees is a measure used to alleviate symptoms associated with hyperventilation but does not directly address the underlying respiratory alkalosis.
B. Having the client breathe into a paper bag helps retain carbon dioxide, which can help reverse respiratory alkalosis by increasing PaCO2 levels and subsequently decreasing pH.
C. Administering sodium bicarbonate would worsen alkalosis by further increasing the pH and bicarbonate levels.
D. Administering insulin is not indicated for respiratory alkalosis and hyperventilation.
Correct Answer is B
Explanation
A. This option can be ruled out because the pH and PaCO2 levels indicate acidosis, but the compensation is not partial as the HCO3 is also low.
B. Maria's symptoms and the arterial blood gas values support this diagnosis. Metabolic acidosis is indicated by a low pH and a decreased bicarbonate (HCO3) level. The body attempts to compensate for this acidosis by hyperventilating, which is evidenced by her Kussmaul breathing, to decrease PaCO2. This compensation is partial because, despite the body's efforts, the pH is still significantly lower than normal.
C. This option can be ruled out because the pH is low (acidosis) rather than high (alkalosis), and the HCO3 is low rather than high.
D. Respiratory Acidosis, Uncompensated is ruled out because the pH is low (acidosis), but the PaCO2 is normal, indicating metabolic rather than respiratory involvement.
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