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 C
Explanation
A. The pH is alkalotic, and the PaCO2 is within the normal range, indicating respiratory alkalosis, which is not typically seen in chronic kidney disease.
B. The pH is alkalotic, and the HCO3 level is lower than normal, indicating metabolic acidosis, which can occur in chronic kidney disease, but the PaCO2 is not typically decreased in metabolic acidosis.
C. This choice fits the pattern of metabolic acidosis commonly seen in CKD patients. In patients with chronic kidney disease (CKD), the kidneys are less able to excrete acid, leading to metabolic acidosis. Therefore, the expected arterial blood gas values would show a lower pH indicating acidemia, a decreased bicarbonate (HCO3-) level, and a normal or low partial pressure of carbon dioxide (PaCO2) as the lungs try to compensate by blowing off CO2.
D. The pH is acidic, and the HCO3 level is within the normal range, indicating respiratory acidosis, which is not typically seen in chronic kidney disease.
Correct Answer is A
Explanation
A. Hyperkalemia is a common finding in the oliguric phase of acute kidney injury due to impaired renal function, leading to decreased potassium excretion.
B. Hypomagnesemia is not typically associated with the oliguric phase of acute kidney injury.
C. In the oliguric phase, the glomerular filtration rate is typically decreased, not increased.
D. In acute kidney injury, creatinine levels typically rise due to decreased renal function, rather than decrease.
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