Metabolic Alkalosis
Diana Jackson (pronouns: she, her, hers) is a 37-year-old client who presents to the emergency department (ED) with severe vomiting for 72 hours. She is irritable and lethargic with muscle cramps and hand tremors. Arterial blood gas results are pH 7.51, HCO3- 36 mEq/L, PaCO2 60 mmHg, and PaO2 90 mmHg. The client has ___metabolic alkalosis
partially compensated
The nurse is caring for a client in the emergency department (ED) with suspected food poisoning from a local seafood restaurant. Arterial blood gas results are: pH 7.51 PaCO2 48 mmHg HCO3- 31 mEq/L The client has _________metabolic alkalosis.
partially compensated
Marcus Monroe (pronouns: he/him/his) is a 45-year-old client who presents to the emergency department (ED) following a motorcycle accident. He has a lacerated liver and spleen as well as several broken ribs. While awaiting surgery, he received 10 units of blood. Vital signs are T 97.6 °F (36.4 °C), P 125, R 28, and BP 85/54.
receiving 10 units of blood
New lab results are in: Vital signs are T 100.8 °F (38.2 °C), P 109, R 12, and BP 95/72. For each potential nursing action, indicate if each is essential, non-essential, or contraindicated at this time.
see picture for answer and rationale
The cause of the client's acid-base imbalance is_____
too much bicarbonate
Which medical conditions may result in metabolic alkalosis? Select all that apply.
trauma requiring blood transfusion ng tube w suction
Which assessment findings are consistent with metabolic alkalosis? Select all that apply.
trousseau's sign hypokalemia hypoventilation
The nurse is caring for a client in the emergency department (ED) who was in a motor vehicle accident and is bleeding internally. Thus far, eight bags of packed red blood cells have been administered. Arterial blood gas results are: pH 7.48 PaCO2 40 mmHg HCO3- 35 mEq/L The client has ____compensated metabolic alkalosis.
uncompensated
_____ BicarbonateCitrate is added as an anticoagulant to blood bags and is converted to ______in the liver. Liver damage leads to further citrate elevation and lower serum calcium, causing _______. _________
citrate bicarbonate metabolic alkalosis
Based on the arterial blood gas results, the client's condition has
improved
Metabolic alkalosis results in _____ pH and ____ HCO3-.
increased increased ABG results: pH greater than 7.45 PaCO2 35-45 mmHg (may increase due to respiratory compensation) HCO3 greater than 26 mEq/L PaO2 normal
The healthcare provider prescribes arterial blood gas analysis. The nurse anticipates the results will show a/an _______pH and a/an _______ HCO3- leading to isotonic fluid hydration and the administration of________
increased increased calcium gluconate
the cause of dianas acid base imabalnce is ______
loss of acid
What is the priority action by the nurse after contacting the healthcare provider?
monitor for cardiac dysrhythmias
Which nursing actions are necessary when administering calcium gluconate? Select all that apply.
Dilute 10% calcium gluconate in dextrose or normal saline for administration. Maintain continuous electrocardiogram monitoring while administering. Repeat calcium gluconate as prescribed until symptoms resolve.
Metabolic alkalosis is the accumulation of bicarbonate and occurs due to the loss of acid or a gain in bicarbonate.
Metabolic alkalosis is the accumulation of bicarbonate and occurs due to the loss of acid or a gain in bicarbonate.
The nurse is caring for a client who is one day post-operative from bowel resection surgery. The client has a nasogastric tube draining a large amount (900 mL in 2 hours) of secretions that look like coffee grounds. The client appears confused, lethargic, anxious, and irritable. Vital signs are T 100.6 °F (38.1 °C), P 122, R 10, and BP 92/66. Arterial blood gas results are pH 7.56, PaCO2 49 mmHg, and HCO3- 32 mEq/L. How should the nurse report these findings?
Metabolic alkalosis, partially compensated