MyLab M. 1.2

A child is being treated for metabolic alkalosis secondary to prolonged vomiting. While the vomiting has decreased due to medication administration, the child is still experiencing episodes of vomiting. Which instruction should the nurse include in teaching to the family to best prevent injury due to vomiting? ANSWER Positioning Cutting food into small pieces Signs and symptoms of aspiration Postvomit oral care

positioning

The excess of which electrolyte in relation to the amount of hydrogen ions contributes to the development of metabolic alkalosis? - Sodium - Bicarbonate - Calcium - Potassium

bicarbonate

Which surgery, when performed with younger children, particularly predisposes them to metabolic alkalosis? ANSWER Pulmonary Neurological Orthopedic Cardiac

cardiac

which extracellular fluid anion is replaced by bicarbonate when depleted, leading to metabolic alkalosis - sodium - potassium - chloride - calcium

chloride

The nurse is teaching a group of older adults at a community center about behaviors that can help reduce the risk of development of acid-base imbalances, such as metabolic alkalosis. Which participant statement indicates a need for further clarification? ANSWER "I should make sure to get enough potassium because I take furosemide." "I can use antacids as long as I don't overdo it." "I should drink 8-10 glasses of water a day even if I don't feel thirsty." "I will weigh myself daily and let the healthcare provider know about significant changes."

"I can use antacids as long as I don't overdo it."

The nurse is caring for a patient with metabolic alkalosis. A prescription has been received to begin a sodium chloride infusion. The family asks why this is being used.Which response by the nurse is best? - "We just needed to establish intravenous access for now; this is a solution commonly used for that purpose." - "The sodium chloride solution will help to correct all of the electrolyte imbalances that have occurred." - "The sodium chloride solution will help to replenish extracellular fluid volume and excrete bicarbonate, which is causing the problem." - "It is just being used for stabilization at this point; soon, something else will be added to address the metabolic alkalosis."

"The sodium chloride solution will help to replenish extracellular fluid volume and excrete bicarbonate, which is causing the problem."

The nurse is completing an assessment on a female teenager with suspected metabolic alkalosis and a history of an eating disorder. Which question should the nurse ask the family of the patient that could best help to identify a potential cause? - "Does your daughter frequently use laxatives? - "Does your daughter purge frequently with her eating disorder?" - "Does your daughter ingest enough calories in a 24-hour period to maintain adequate nutritional status?" - "Does your daughter use diuretics in an attempt to keep her weight down?"

- "Does your daughter purge frequently with her eating disorder?"

An older adult patient is being discharged for treatment of metabolic alkalosis. Which teaching should the nurse include concerning decreased thirst sensation due to changes of aging? ANSWER - "You need to log everything that you drink and the amount of urine that you excrete as much as possible." - "It is important that you keep track of and make sure to drink 8-10 glasses of water a day." - "Make sure that you only use antacids that are not bicarbonate based." - "You should weigh yourself daily under the same conditions every time so that you know if you need to be drinking more fluids."

- "It is important that you keep track of and make sure to drink 8-10 glasses of water a day."

The nurse is reviewing the results of a patient's arterial blood gas (ABG). Which ABG interpretation would indicate that this patient is experiencing metabolic alkalosis? - Elevated pH, elevated HCO3 - Decreased pH, elevated HCO3 - Decreased pH, normal HCO3 - Elevated pH, normal HCO3

- Elevated pH, elevated HCO3

A 7-year-old child is admitted with intractable nausea and vomiting. The patient's current arterial blood gas (ABG) results are as follows: pH 7.50; pCO2 46 mmHg; pO2 95 mmHg; HCO3 34 mEq/L. According to the patient's ABGs, what pharmacologic therapy should the nurse expect to be ordered? - Sodium chloride - Magnesium chloride - Calcium chloride - Sodium bicarbonate

- Sodium chloride

a preschool age patient requires a nasogastric tube for gastric suctioning. due to the risk of developing metabolic alkalosis for which symptom should the nurse monitor - hypertension - dysrhythmia - increased temperature - tachypnea

- dysrhythmia

a patient is diagnosed with metabolic alkalosis secondary. to primary hyperaldosteronism. the patient appears short of breath, requiring supplemental oxygen therapy to maintain an oxygen saturation greater than 93%. which intervention should the nurse implement to help the patient respiratory status? - clustering many nursing care activities together - measuring intake and output - elevating the head of the bed to fowler position - turning the patient frequently

- elevating the head of the bed to fowler position

a patient with metabolic alkalosis is on continuous cardiac monitoring. which finding by the nurse confirms the need for monitoring? - potassium level of 3.2 mEq/L - Urine output of 600 mL per 12-hour shift - Change in weight of 1 pound in 24 hours - Oxygen saturation of 95%

- potassium level of 3.2 mEq/L

what is the desired overall outcome for a patient with metabolic alkalosis? - restore and maintain normal acid-base balance - prevent complications of metabolic alkalosis - resolve the underlying cause of the metabolic alkalosis - maintain adequate fluid volume balance

- restore and maintain normal acid-base balance

the nurse is caring for a patient with severe muscle spasm, metabolic alkalosis, and a history of primary hyperaldosteronism. based on this diagnosis, which assessment should the nurse include in the physical examination of this patient? - date of the last menstraul cycle. - length of time patient has been experiencing dizziness. -deep tendon reflexes - current medicsations

-deep. tendon reflexes

The nurse is administering IV fluids rapidly to address deficient fluid volume in a patient with metabolic alkalosis. Which independent nursing intervention would best help to prevent fluid volume overload in this patient? ANSWER Monitoring frequently for indicators of fluid overload Administering the IV fluids via an infusion pump Assessing for signs and symptoms of pulmonary edema Maintaining the patient in a Fowler position

Administering the IV fluids via an infusion pump

A patient diagnosed with metabolic alkalosis is complaining of numbness and tingling around the mouth and in both upper extremities. The nurse should understand that which statement supports the etiology of this condition? ANSWER Hyperkalemia leads to a loss of hydrogen ions, making body fluids more alkaline. Toxic levels of salicylate increase acid loss, increasing alkalinity. Administration of sodium bicarbonate increases serum bicarbonate, making body fluids more alkaline. Chronic kidney disease results in excess acid excretion, increasing alkalinity.

Administration of sodium bicarbonate increases serum bicarbonate, making body fluids more alkaline.

Which effect of loop diuretic therapy contributes most directly to the development of metabolic alkalosis in older adults? ANSWER Lowered blood pressure Increased urinary output Depletion of sodium, chloride, and potassium Slower excretion of the loop diuretic

Depletion of sodium, chloride, and potassium

A patient reports numbness and tingling in her fingers. The nurse notes that the individual has recently taken "a lot" of antacids due to "an upset stomach." Which additional clinical finding should the nurse anticipate when conducting the patient's assessment? ANSWER Muscle weakness Dizziness Hypertension Hyperkalemia

Dizziness

The nurse places the patient experiencing metabolic alkalosis in semi-Fowler position. Which rationale supports placing the patient in this position to address impaired gas exchange? ANSWER Elevating the head of the bed helps to conserve energy. Elevating the head of the bed decreases dyspnea by allowing better contraction of the diaphragm. Elevating the head of the bed facilitates alveolar ventilation and gas exchange. Elevating the head of the bed facilitates secretion clearance.

Elevating the head of the bed facilitates alveolar ventilation and gas exchange.

The nurse is providing care for a patient with metabolic alkalosis secondary to the excessive use of loop diuretics. Which amount of urine output should indicate to the nurse that the patient potentially has deficient fluid volume? ANSWER Less than 30 mL/hour Less than 1000 mL/24 hours Intake to output excess of 100 mL 45 mL/hour

Less than 30 mL/hour

The nurse is caring for a preschool-age patient who is experiencing excessive vomiting. For which reason should the nurse be concerned that the patient may develop metabolic alkalosis? ANSWER Loss of hydrogen ions Excessive loss of bicarbonate Hyperkalemia Excessive use of bicarbonate

Loss of hydrogen ions

A young female with a binging and purging disorder is admitted with complaints of numbness and tingling of the fingers and toes accompanied by dizziness. Which acid-base imbalance should the nurse suspect? ANSWER Respiratory acidosis Metabolic acidosis Metabolic alkalosis Respiratory alkalosis

Metabolic alkalosis

The nurse is caring for a patient admitted for metabolic alkalosis. Which laboratory value does the nurse anticipate for a patient experiencing this acid-base imbalance? ANSWER Sodium of 136 mEq/L Chloride of 100 mEq/L Potassium of 3.0 mEq/L Total calcium of 5.7 mEq/L

Potassium of 3.0 mEq/L

The nurse is providing a teaching session to colleagues concerning the needs of older adults. Which should the nurse include in the teaching session concerning changes of aging that best addresses the risk for dehydration? ANSWER Ensure easy access to drinking water to address changes in vision and mobility. Remind older adults to drink fluids throughout the day to address the decreased sense of thirst. Keep older adults active to increase declining metabolism and stimulate appetite and thirst. Encourage older adults to eat foods rich in potassium because most are receiving diuretics secondary to decreasing renal function.

Remind older adults to drink fluids throughout the day to address the decreased sense of thirst.

For which clinical manifestation should the nurse monitor when caring for a patient with metabolic alkalosis? ANSWER Tachypnea Hypertension Muscle weakness Seizures

Seizures

The nurse is preparing to discharge a patient who has been treated for metabolic alkalosis secondary to excessive use of bicarbonate antacids. Which outcome for the patient should the nurse consider to be most appropriate post-hospitalization? ANSWER The patient will identify the signs and symptoms of metabolic alkalosis. The patient will verbalize when to contact the healthcare provider. The patient will describe when to notify the healthcare provider related to changes in daily weight. The patient will report the appropriate use of acceptable antacids.

The patient will report the appropriate use of acceptable antacids.

The nurse is reviewing sets of arterial blood gases (ABGs) for the patients on the unit. Which set of ABGs would indicate fully compensated metabolic alkalosis? ANSWER pH 7.24; PaCO2 33 mmHg; HCO3 14 mEq/L pH 7.26; PaCO2 55 mmHg; HCO3 24 mEq/L pH 7.44; PaCO2 29 mmHg; HCO3 19 mEq/L pH 7.45; PaCO2 47 mmHg; HCO3 30 mEq/L

pH 7.45; PaCO2 47 mmHg; HCO3 30 mEq/L

The nurse is caring for a patient with metabolic alkalosis. Which set of ABGs should the nurse interpret as uncompensated metabolic alkalosis in this patient? ANSWER pH 7.42; PaCO2 29 mmHg; HCO3 17 mEq/L pH 7.38; PaCO2 38 mmHg; HCO3 24 mEq/L pH 7.24; PaCO2 36 mmHg; HCO3 18 mEq/L pH 7.52; PaCO2 48 mmHg; HCO3 29 mEq/L

pH 7.52; PaCO2 48 mmHg; HCO3 29 mEq/L

Which diagnostic study reflects the kidney's ability to regulate hydrogen ion and bicarbonate concentrations in the blood? ANSWER Urine pH Urine leukocyte esterase levels Urine protein levels Urine specific gravity

Urine pH

Which intervention should the nurse include in the plan of care for an older adult patient experiencing metabolic alkalosis to most accurately reflect fluid balance? ANSWER Monitoring serum electrolytes every 24 hours Assessing for hypotension and tachycardia every 4 hours Weighing daily under standard conditions Measuring intake and output balance at the end of each shift

Weighing daily under standard conditions