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 B

Explanation

A. Respiratory Acidosis, both compensated and uncompensated, is characterized by an elevated PaCO2, which is not present in this case.
B. The elevated pH (7.5) and HCO3 (34 mmol/L) indicate metabolic alkalosis. The elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest the partially compensated state, which is the respiratory compensation attempting to correct the alkalosis.
C. The fact that the PaCO2 is not low rules out respiratory alkalosis.
D. The arterial blood gas values indicate a high pH (7.5), a normal PaCO2 (40 mm Hg), and an elevated HCO3 (34 mmol/L), which are indicative of metabolic alkalosis. However, the elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest a partially compensated state.

A. Maintain an IV of 0.45% sodium chloride. B. Administer desmopressin acetate 0.2 mg orally. C. Provide a diet containing 2 g of sodium per day. D. Restrict fluid intake to 1,000 mL per day.

Correct Answer is D

Explanation

A. Infusing hypotonic fluids such as 0.45% sodium chloride can exacerbate hyponatremia in a client with SIADH by further diluting serum sodium levels.
B. Desmopressin acetate is a synthetic form of ADH and would exacerbate the symptoms of SIADH by increasing water reabsorption and further diluting serum sodium levels.
C. Increasing dietary sodium intake would not be appropriate for a client with SIADH, as it would contribute to further fluid retention and exacerbate hyponatremia.
D. Fluid restriction is a key component of managing SIADH to prevent further water retention and dilutional hyponatremia. Restricting fluid intake helps to normalize serum sodium levels by allowing excess water to be excreted.

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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

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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