A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take first?
Place the client on continuous cardiac monitoring.
Obtain a prescription for insulin for the client.
Plan to administer sodium bicarbonate to the client.
Have the client breathe into a paper bag.
The Correct Answer is A
The correct answer is: A. Place the client on continuous cardiac monitoring.
Choice A reason:
Placing the client on continuous cardiac monitoring is crucial because metabolic alkalosis can lead to life-threatening arrhythmias due to electrolyte imbalances, particularly hypokalemia. Continuous monitoring allows for the early detection and management of these arrhythmias, ensuring patient safety.
Choice B reason:
Obtaining a prescription for insulin is not relevant for treating metabolic alkalosis. Insulin is typically used for managing hyperglycemia and diabetic ketoacidosis, not for correcting alkalosis.
Choice C reason:
Planning to administer sodium bicarbonate is incorrect because sodium bicarbonate is used to treat metabolic acidosis, not alkalosis. Administering it in this context could worsen the alkalosis.
Choice D reason:
Having the client breathe into a paper bag is a technique used for respiratory alkalosis to increase CO2 levels. It is not appropriate for metabolic alkalosis, which requires different management strategies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Doing wheelchair exercises sitting in the chair is a correct statement, as it helps to prevent pressure ulcers, improve circulation, and maintain muscle tone.
Choice B reason: Using a suppository every night to have a bowel movement is an incorrect statement, as it indicates a dependence on laxatives and a lack of bowel training. The adolescent should be taught to establish a regular bowel routine, use natural methods such as abdominal massage and digital stimulation, and avoid overuse of laxatives.
Choice C reason: Needing to catheterize oneself twice a day is a correct statement, as it helps to prevent urinary tract infections, bladder distension, and kidney damage.
Choice D reason: Carrying a water bottle with me because I drink a lot of water is a correct statement, as it helps to prevent dehydration, constipation, and urinary tract infections.
Correct Answer is B
Explanation
Choice A: Taking the client to the bathroom every 2 hours while awake is not an effective strategy for bowel training. This may disrupt the client's natural bowel rhythm and cause unnecessary stress and frustration. Bowel training aims to establish a regular and predictable time for elimination, not a frequent and arbitrary one¹².
Choice B: Taking the client to the bathroom when they have the urge to defecate is the best option for bowel training. This helps the client to respond to their body's signals and avoid suppressing or delaying the urge. It also reinforces the association between the urge and the act of defecation, which can improve bowel control and prevent constipation¹².
Choice C: Taking the client to the bathroom immediately before meals is not a good idea for bowel training. This may interfere with the client's appetite and digestion, as well as their social and emotional well-being. Bowel training should not be associated with negative or unpleasant feelings. Moreover, eating stimulates the gastrocolic reflex, which increases the motility of the colon and the likelihood of having a bowel movement after a meal¹³.
Choice D: Taking the client to the bathroom after they feel abdominal cramping is not a reliable method for bowel training. Abdominal cramping may indicate various conditions, such as irritable bowel syndrome, food intolerance, infection, or inflammation. It may not always be related to the need to defecate. Waiting for cramping to occur may also delay the evacuation and worsen the symptoms¹³.
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