A nurse is reinforcing teaching about elimination with an adolescent who is paralyzed from the waist down following a spinal cord injury.
Which statement by the adolescent indicates a need for further teaching?

Choice A rationale:

Metabolic alkalosis Metabolic alkalosis is a condition that occurs when your body has too many bases. It can occur due to prolonged vomiting, use of diuretics, or an overuse of antacids. In the context of Chronic Obstructive Pulmonary Disease (COPD), metabolic alkalosis is not typically a direct result of the disease. COPD primarily affects the respiratory system and does not directly cause an imbalance of bases in the body.

Choice B rationale:

Respiratory acidosis Respiratory acidosis is a condition that occurs when the lungs can’t remove enough carbon dioxide (CO2). This leads to a buildup of CO2 in the body, causing the pH of the blood to decrease and become more acidic. This is the most common acid-base imbalance seen in patients with COPD1. COPD can cause an alteration in respiratory exchanges, leading to retention of CO21. The consequence of hypercapnia due to alteration of gas exchange in COPD patients mainly consists in an increase of H+ concentration and development of respiratory acidosis.

Respiratory alkalosis Respiratory alkalosis is a condition that occurs when there is too little carbon dioxide in the body, often due to hyperventilation. In the context of COPD, this is less likely because COPD patients often have difficulty expelling carbon dioxide, not an excess of it being expelled.

Choice D rationale:

Metabolic Acidosis Metabolic acidosis occurs when the body produces too much acid, or when the kidneys are not removing enough acid from the body. This can occur due to conditions such as kidney disease, lactic acidosis, or ketoacidosis. While COPD can have wide-ranging effects on the body, it does not typically cause metabolic acidosis directly.

Choice A rationale:

Wheezing Wheezing is typically associated with respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD), rather than being a symptom of hyperkalemia.

Choice B rationale:

Cerebral edema Cerebral edema, or swelling in the brain, is not typically a symptom of hyperkalemia. It’s more commonly associated with traumatic brain injury, stroke, or brain tumors.

Choice C rationale:

Decreased deep tendon reflexes Decreased deep tendon reflexes can be a symptom of hyperkalemia. Hyperkalemia is a condition in which the potassium levels in your blood get too high. Potassium helps nerves send signals between your brain and the rest of your body. High levels of potassium can affect nerve function, leading to symptoms such as muscle weakness or decreased reflexes. Choice D rationale:

Hypoactive bowel sounds Hypoactive bowel sounds, or decreased or absent bowel sounds, are typically associated with conditions affecting the gastrointestinal system, such as ileus or bowel obstruction. They are not typically a symptom of hyperkalemia.