NUR 200 1.3 Review: Metabolic Alkalosis
The nurse is caring for a client, admitted with metabolic alkalosis, who is complaining of numbness and tingling around the mouth and in both upper extremities. Which statements are true regarding the etiology of this condition? (Select all that apply.) Administration of sodium bicarbonate increases serum bicarbonate, making body fluids more alkaline. Vomiting leads to a loss of hydrogen ions, making body fluids more alkaline. Hyperkalemia leads to a loss of hydrogen ions, making body fluids more alkaline. Excessive adrenal corticoid hormone leads to hypokalemia and a loss of hydrogen ions, making body fluids more alkaline. Gastric suction leads to a loss of hydrogen ions, making body fluids more alkaline.
-Administration of sodium bicarbonate increases serum bicarbonate, making body fluids more alkaline. -Vomiting leads to a loss of hydrogen ions, making body fluids more alkaline. -Excessive adrenal corticoid hormone leads to hypokalemia and a loss of hydrogen ions, making body fluids more alkaline. -Gastric suction leads to a loss of hydrogen ions, making body fluids more alkaline. Rationale Hypokalemia, not hyperkalemia, leads to a loss of hydrogen ions, making body fluids more alkaline and causes metabolic alkalosis. All other statements are true.
The nurse is caring for a client diagnosed with metabolic alkalosis. Which intervention should the nurse include when establishing the plan of care? Promote early ambulation. Administer antiemetics as prescribed. Encourage slow, deep respirations. Monitor for pain.
Administer antiemetics as prescribed. Rationale One cause of metabolic alkalosis is vomiting. Antiemetics can help prevent this from occurring. Acute pain that might require medication is seen with respiratory, not metabolic, alkalosis. Encouraging slow, deep respirations would be indicated for a patient with respiratory alkalosis. Early ambulation is encouraged with respiratory acidosis, not with metabolic alkalosis.
A client is diagnosed with metabolic alkalosis. What action by the nurse will assist in restoring this imbalance? Administering sodium bicarbonate Administering IV insulin Administering a bronchodilator Administering potassium chloride
Administering potassium chloride Rationale In metabolic alkalosis, the administration of potassium restores serum and intracellular potassium levels, allowing the kidneys to conserve hydrogen ions. Sodium bicarbonate is used to treat metabolic acidosis, not metabolic alkalosis. IV insulin is used to treat diabetic ketoacidosis, which occurs with metabolic acidosis, not metabolic alkalosis. Bronchodilators are used to treat respiratory acidosis, not metabolic alkalosis
A nurse is caring for a client whose arterial blood gas (ABG) results are as follows: pH 7.47 pCO2 35 pO2 90 HCO3 35 Which pharmacological therapy will the nurse anticipate administering for this client to help restore the client's acid-base balance? (Select all that apply.) Ammonium chloride Potassium chloride Sodium chloride Magnesium chloride Calcium chloride
Ammonium chloride Potassium chloride Sodium chloride Rationale This client has metabolic alkalosis. Pharmacological therapy for this condition includes: potassium chloride, sodium chloride, and ammonium chloride. While this client may have other electrolyte imbalances, magnesium chloride and calcium chloride are not typical therapies for the treatment of metabolic alkalosis.
The nurse is caring for a client with a severe muscle spasm and a history of primary hyperaldosteronism. The client has been diagnosed with metabolic alkalosis. Based on this diagnosis what should the nurse include in the physical examination of this client during the nursing assessment? Assess deep tendon reflexes Review the client's current medication list Determine the date of the last menstrual cycle Ask the client how long she has been experiencing dizziness
Assess deep tendon reflexes Rationale During the physical examination of a client who is diagnosed with metabolic alkalosis, the nurse would assess deep tendon reflexes. Reviewing the client's current medication list and asking the client how long she has been experiencing dizziness are appropriate actions by the nurse, but these would be completed during the health history. The date of the last menstrual cycle is not pertinent information when assessing a client for metabolic alkalosis.
A nurse is caring for a client who is receiving massive blood transfusions secondary to hypovolemic shock. Which rationale supports assessing this client for metabolic alkalosis? Heparin found in blood products decreases serum potassium. Hypovolemic shock increases the serum pH. Excessive blood transfusions cause hypokalemia. Citrate toxicity decreases serum ionized calcium.
Citrate toxicity decreases serum ionized calcium. Rationale Citrate is a preservative found in blood products. Citrate toxicity decreases serum ionized calcium, leading to metabolic alkalosis. The other statements are incorrect statements.
A preschool-age client requires a nasogastric tube for gastric suctioning. Which symptom will the nurse monitor this client for, due to the risk of metabolic alkalosis? Hypertension Dysrhythmia Increased temperature Tachypnea
Dysrhythmia Rationale Metabolic alkalosis may be caused by gastric suctioning, due to the loss of hydrogen ions. Cardiac dysrhythmia, bradypnea, and hypotension would indicate the client is experiencing metabolic alkalosis. Increased temperature may indicate infection.
The nurse is reviewing the results of a client's arterial blood gas (ABG). Which ABG interpretation would indicate that this client is experiencing metabolic alkalosis? Elevated pH, elevated HCO3 Decreased pH, elevated HCO3 Decreased pH, normal HCO3 Elevated pH, normal HCO3
Elevated pH, elevated HCO3 Rationale Evidence of metabolic alkalosis is an elevated pH and an elevated HCO3. A decreased pH and elevated HCO3 would indicate a partially compensated respiratory acidosis. An elevated pH and normal HCO3 would indicate respiratory alkalosis. A decreased pH and normal HCO3 indicates respiratory acidosis.
The nurse is caring for a client admitted to a medical-surgical unit after a car accident. The client received several units of packed red blood cells while in surgery. The nurse begins to monitor this client for metabolic alkalosis due to receiving blood transfusions. Which other item in the client's health history would place this client at an increased risk for developing metabolic alkalosis? History of breast cancer History of low potassium History of two miscarriages History of depression
History of low potassium Rationale A history of hypokalemia, or low potassium, in addition to the numerous blood transfusions, would place this client at risk for metabolic alkalosis. A history of two miscarriages, breast cancer, and depression do not place this client at a higher risk for developing metabolic alkalosis
A toddler-age client returns from the postanesthesia care unit (PACU) after having an appendectomy. Upon assessment, the nurse notes a dysrhythmia on the child's ECG and a positive Trousseau's sign. The client is diagnosed with metabolic alkalosis. Which nursing intervention is the most appropriate for this client? Monitor for bradycardia. Place the client in high-Fowler position. Assess respiratory status every shift. Weigh the client every other day.
Place the client in high-Fowler position. Rationale A client who is diagnosed with metabolic alkalosis will require positioning in Fowler or high-Fowler to decrease the work of breathing. Respiratory status should be monitored every 2 hours, the client should be weighed every day, and the nurse would monitor for tachycardia.
The nurse is caring for a client admitted for metabolic alkalosis. Which laboratory value does the nurse anticipate for a client experiencing this acid-base imbalance? Chloride of 100 mEq/L Potassium of 3.0 mEq/L Sodium of 136 mEq/L Total calcium of 5.7 mEq/L
Potassium of 3.0 mEq/L Rationale The potassium level will be less than 3.5 mEq/L in a client experiencing metabolic alkalosis. Therefore, a potassium level of 3.0 mEq/L will be seen in a client with metabolic alkalosis. A client experiencing metabolic alkalosis will have a chloride level less than 95 mEq/L. A client who is experiencing metabolic alkalosis will have a normal total calcium that is between 4.5 and 5.5 mEq/L. A client experiencing metabolic alkalosis will have a low sodium level that is below 135 mEq/L.
A nurse is caring for a client who is diagnosed with metabolic alkalosis. What should the nurse include in the assessment of this client? (Select all that apply.) Presence of numbness and tingling ABG interpretation Presence of muscle weakness Deep tendon reflexes Oxygen saturation
Presence of numbness and tingling ABG interpretation Deep tendon reflexes Oxygen saturation Rationale When assessing a client with metabolic alkalosis, the nurse will include ABG interpretation, deep tendon reflexes, oxygen saturation, and presence of numbness and tingling. The nurse would assess for the presence of muscle spasm, not weakness, for this client.