A student nurse is working with their preceptor on a medical-surgical unit. While reviewing concepts related to acid-base balance, what should the preceptor state is a compensatory mechanism for metabolic alkalosis?

Kidney conservation of bicarbonate and excretion of hydrogen ions

Deep, rapid respirations to increase CO2 excretion

Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate

Shifting of bicarbonate into cells in exchange for chloride

Answer and Explanation

The Correct Answer is C

A. Kidney conservation of bicarbonate and excretion of hydrogen ions: This option is not correct for metabolic alkalosis. In metabolic alkalosis, the kidneys would typically excrete bicarbonate rather than conserve it.
B. Deep, rapid respirations to increase CO2 excretion: This is incorrect because deep, rapid respirations are more associated with compensating for metabolic acidosis by increasing CO2 excretion. In metabolic alkalosis, the body attempts to retain CO2.
C. Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate: This is the correct choice. In metabolic alkalosis, the body compensates by reducing respiration rate (hypoventilation) to retain CO2, which helps to counteract the elevated pH. Additionally, the kidneys may excrete bicarbonate to balance the pH.
D. Shifting of bicarbonate into cells in exchange for chloride: This mechanism is more related to respiratory alkalosis rather than metabolic alkalosis. In metabolic alkalosis, the primary compensatory mechanisms involve changes in respiratory rate and renal bicarbonate excretion.

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Correct Answer is D

Explanation

A. Increased cardiac output: In older adults, cardiac output typically decreases, not increases, and this has a minor impact on nutritional status.
B. An increase in GI motility and absorption: GI motility and absorption generally decrease with age, not increase, which can affect nutritional status.
C. Constant snacking between meals that results in obesity: Obesity is less common in healthy older adults compared to issues related to malnutrition or economic factors.
D. Living alone on a fixed income: This can significantly impact nutritional status due to potential financial constraints affecting food availability and quality.

A. Vomiting B. Tachycardia C. Deep rapid breathing D. Watery diarrhea

Correct Answer is C

Explanation

A. Vomiting: Vomiting is a common symptom associated with metabolic acidosis but is not a compensatory mechanism. It can lead to further electrolyte imbalances and dehydration.
B. Tachycardia: Tachycardia can occur as a response to acidosis but is not a direct compensatory mechanism for metabolic acidosis.
C. Deep rapid breathing: This is the correct choice. Deep rapid breathing, or Kussmaul respirations, is a compensatory mechanism for metabolic acidosis. It helps to expel carbon dioxide, thereby reducing acidity in the blood.
D. Watery diarrhea: Diarrhea can contribute to electrolyte imbalances and may exacerbate acidosis but is not a compensatory response by the body.

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A student nurse is working with their preceptor on a medical-surgical unit. While reviewing concepts related to acid-base balance, what should the preceptor state is a compensatory mechanism for metabolic alkalosis?

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