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

Answer and Explanation

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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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.

A. Obtain a prescription for insulin for the client. B. Have the client breath into a paper bag. C. Place the client on continuous cardiac monitoring, D. Plan to administer sodium bicarbonate to the client.

Correct Answer is C

Explanation

A. Insulin administration is not indicated for metabolic alkalosis.
B. Breathing into a paper bag is a treatment for respiratory alkalosis, not metabolic alkalosis.
C. Metabolic alkalosis can lead to cardiac dysrhythmias due to electrolyte imbalances, particularly hypokalemia. Continuous cardiac monitoring is essential to promptly identify and manage any dysrhythmias that may occur.
D. Administering sodium bicarbonate would exacerbate metabolic alkalosis and is not indicated.

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A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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