Acid base balance Exemplar 1.B Metabolic Alkalosis
Clinical manifestations of metabolic alkalosis are similar to signs of A) hypocalcemia. B) hypokalemia. C) hypercalcemia. D) hyperkalemia.
A
client with hyperaldosteronism is admitted to the unit and is at risk for impaired gas exchange. In which position should this client be placed to enhance gas exchange? A) Fowler position B) Prone position C) Left side-lying position D) Right Sims position
A
The nurse identifies the diagnosis Risk for Impaired Gas Exchange to guide the care of a client with metabolic alkalosis. Which assessment data supports this nursing diagnosis? Select all that apply. A) Respiratory rate 8 per minute B) Oxygen saturation 89% C) Urine output 25 mL/hr D) Restlessness and agitation E) Weight loss of 3 kg overnight
ABD
nurse is caring for a client who has been admitted to the hospital for congestive heart failure. Which data collected during the nursing assessment indicate that the client is at risk for metabolic alkalosis? Select all that apply. A) The client takes furosemide (Lasix) daily. B) The client takes a baby aspirin once daily. C) The client takes metformin daily. D) The client frequently uses calcium carbonate (Tums) for acid indigestion. E) The client takes acetaminophen as needed for pain.
AD
A client with severe metabolic alkalosis is admitted to the unit. Which is the priority for the client? A) Administering medication for metabolic alkalosis B) Monitoring oxygen saturation C) Teaching the client the risk factors for metabolic alkalosis D) Setting goals for the client with metabolic alkalosis
B
The nurse is planning care for the client with Cushing syndrome who has been admitted for complications related to the disease process. Which intervention should the nurse plan for this client to improve the impaired gas exchange? A) Monitor serum electrolytes. B) Schedule nursing activities to allow for periods of rest. C) Assess input and output accurately. D) Administer IV fluids per practitioner order.
B
client is admitted with manifestations of metabolic alkalosis. Which diagnostic test findings support the admitting diagnosis? Select all that apply. A) Serum glucose level 142 mg/dL B) Blood pH 7.47 and bicarbonate 34 mEq/L C) Intravenous pyelogram shows kidney stones D) Bilateral lower lobe infiltrates noted on chest x-ray E) Electrocardiogram changes consistent with hypokalemia
BE
A newborn with pyloric stenosis has symptoms of projectile vomiting, leading to significant weight loss, dehydration, and metabolic alkalosis. What client teaching is necessary for the parents in caring for the infant until surgery to correct the defect? A) Monitoring for hyperventilation to detect changes in health status B) Breastfeeding techniques to reverse weight loss and dehydration C) Positioning of the infant to prevent aspiration D) Performing percussion and postural drainage to clear the airways
C
During a home visit, the nurse evaluates teaching provided to a client recently hospitalized for metabolic alkalosis. Which observation indicates that additional teaching is required? A) Drinks 2 cups of black coffee each day. B) Consumes one orange each day with breakfast. C) Ingests bicarbonate of soda after each meal. D) Monitors and tracks daily weights.
C
During an assessment, the nurse becomes concerned that a client is at risk for developing metabolic alkalosis. What did the nurse assess that caused this concern? A) Daily ingestion of a banana with breakfast B) Daily weight consistent C) Daily use of sodium bicarbonate for gastric upset D) Daily use of prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritic pain
C
The client has been vomiting for several days. The nurse knows that the client is at risk for metabolic alkalosis because gastric secretions have which characteristic? A) Gastric secretions are green in color. B) Gastric secretions are alkaline. C) Gastric secretions are acidic. D) Gastric secretions have a foul smell.
C
The nurse is preparing to discharge a client with congestive heart failure on furosemide (Lasix). The nurse determines that teaching has been effective if the client makes which statement? A) "I will use only sodium bicarbonate as my antacid." B) "I will restrict my intake of fluids." C) "I will use potassium supplements while I am taking Lasix." D) "I will take antacids only for my gastric discomforts."
C
While reviewing laboratory results, the nurse notes that a client's potassium level is 2.8 mEq/L and chloride level is 100 mEq/L. Based on this data, which intervention does the nurse plan for this client? A) Preparing to administer 0.9% sodium chloride infusion B) Measuring for nasogastric tube insertion C) Discussing potassium chloride replacement therapy with the healthcare provider D) Reviewing implications of transfusing with ammonium chloride
C
adolescent is hospitalized following several days of vomiting due to food poisoning. The nurse is planning to include which points when teaching the client's family at discharge? Select all that apply. A) Immunizations for the adolescent B) Nutritional patterns of the adolescent C) Signs and symptoms of metabolic alkalosis D) Proper food-handling techniques E) Normal laboratory values of the adolescent
CD
The nurse is planning care for the client who has been admitted with metabolic alkalosis. Which are appropriate nursing diagnoses for this client during the acute phase of the illness? Select all that apply. A) Ineffective Health Maintenance B) Risk for Hypothermia C) Deficient Fluid Volume D) Risk for Impaired Gas Exchange E) Risk for Injury
CDE