A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

Place the client on seizure precautions.

Have the client breath into a paper bag.

Encourage the client to breath slowly,

Plan to administer sodium bicarbonate to the client

Answer and Explanation

The Correct Answer is A

A. Placing the client on seizure precautions is important as metabolic alkalosis can cause neurological symptoms, such as confusion and increased risk for seizures due to electrolyte imbalances (e.g., low calcium levels). Therefore, seizure precautions are warranted.
B. Breathing into a paper bag is used in respiratory alkalosis to increase CO2 levels, but it is not appropriate in metabolic alkalosis, where the issue is not primarily related to CO2 imbalance.
C. Encouraging the client to breathe slowly is generally more appropriate for respiratory alkalosis, not metabolic alkalosis. Slow breathing would not directly address the underlying issue of metabolic alkalosis.
D. Administering sodium bicarbonate would worsen metabolic alkalosis, as it would further increase the alkalotic state. Sodium bicarbonate is used in metabolic acidosis, not alkalosis.

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Correct Answer is D

Explanation

A. Respiratory acidosis would typically involve an elevated PaCO2, which is not seen in this case.
B. Metabolic alkalosis is characterized by an elevated bicarbonate level, which is not present in this scenario.
C. Respiratory alkalosis would present with a low PaCO2 and an elevated pH, which is not the case here.
D. The low bicarbonate level (HCO3) 18mEq/L (normal range of 22-26 mEq/L), and low pH 7.30 (normal range of 7.35-7.45), indicate metabolic acidosis. suggesting acidemia. The PaCO2 is also low at 28 mm Hg, indicating a respiratory compensation for the metabolic acidosis.

A. Bone pain B. Slurred speech C. Hypotension D. Pruritus E. Bradypnea.

Correct Answer is ["A","B","D"]

Explanation

A. Bone pain can occur in ESRD due to mineral and bone disorders associated with chronic kidney disease.
B. Slurred speech can be seen in ESRD patients with uremic encephalopathy.
C. Hypotension is less common in ESRD; hypertension is more typical due to fluid overload and retention.
D. Pruritus is a common symptom of ESRD, often due to accumulation of uremic toxins.
E. Bradypnea is not typically associated with ESRD.

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A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

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