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.