A nurse in an emergency department is admitting a client who has overdosed on antacids and is in a state of metabolic alkalosis. For which of the following manifestations should the nurse monitor?

A) Cimetidine: Cimetidine is an H2 receptor antagonist used to reduce stomach acid and treat conditions such as peptic ulcers and gastroesophageal reflux disease (GERD). It is not used to manage metabolic acidosis.

B) Calcitonin: Calcitonin is used to regulate calcium levels and treat conditions like osteoporosis or hypercalcemia. It does not address metabolic acidosis and is not appropriate for this condition.

C) Sodium bicarbonate: Sodium bicarbonate is commonly used to treat metabolic acidosis. It works by neutralizing excess acid in the blood, thereby increasing the blood's pH and helping to correct the acid-base imbalance associated with metabolic acidosis.

D) Sodium chloride: Sodium chloride is a salt that can be used to manage fluid and electrolyte imbalances but does not correct metabolic acidosis. It is not suitable for treating the acid-base imbalance seen in metabolic acidosis.

A) Drink 8 oz of milk when hypoglycemia develops:
While consuming a fast-acting carbohydrate is important during hypoglycemia, 8 oz of milk may not be the most effective choice. Typically, glucose tablets or juice are recommended as they provide a quicker absorption of sugar into the bloodstream.

B) Initiate a 1,400-calorie diet daily:
Caloric needs should be individualized based on the adolescent’s age, weight, activity level, and overall health. A fixed 1,400-calorie diet might not be appropriate for every adolescent and could lead to insufficient energy intake or excessive restriction.

C) Rotate the insulin injection site to a different area of the body with every other injection:
While rotating injection sites is important to prevent lipodystrophy, it is generally recommended to use different sites within the same area (such as different spots on the abdomen) rather than entirely different areas of the body with each injection. This ensures consistent absorption of insulin.

D) Keep unopened insulin refrigerated at 4.44° C (40° F):
Unopened insulin should be stored in the refrigerator to maintain its potency until it is ready to be used. This temperature range ensures the insulin remains stable and effective for use.