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A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.).

Lethargy.

Kussmaul's respirations.

Circumoral paresthesia.

Bicarbonate excess.

Flushing

Answer and Explanation

Correct Answer : A,C,D

The correct answer is choice A, C, and D.

Choice A rationale:

Lethargy is a common symptom of metabolic alkalosis due to the body’s attempt to compensate for the altered pH balance, leading to decreased energy levels and fatigue.

Choice B rationale:

Kussmaul’s respirations are typically associated with metabolic acidosis, not alkalosis. These deep, labored breaths are the body’s way of trying to expel excess carbon dioxide to correct acidosis.

Choice C rationale:

Circumoral paresthesia, or tingling around the mouth, is a symptom of metabolic alkalosis. This occurs due to changes in calcium ion concentration affecting nerve function.

Choice D rationale:

Bicarbonate excess is a direct cause of metabolic alkalosis. Elevated bicarbonate levels in the blood lead to an increased pH, resulting in alkalosis.

Choice E rationale:

Flushing is not a typical symptom of metabolic alkalosis. It is more commonly associated with conditions that cause vasodilation or increased blood flow to the skin.

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Correct Answer is D

Explanation

The correct answer is choice D: Reduction of T-wave amplitude.

Choice A rationale:

The amplitude of the QRS complex is not directly affected by changes in serum potassium levels. It represents ventricular depolarization, and its restoration would not be an expected outcome of polystyrene sulfonate treatment

Choice B rationale:

Shortening of the P-wave duration is not an expected change with polystyrene sulfonate treatment. The P-wave represents atrial depolarization, which is not significantly impacted by the administration of this medication

Choice C rationale:

Widening of the QRS complex is associated with high serum potassium levels. The goal of polystyrene sulfonate treatment is to lower potassium levels and, thus, return the QRS complex to its normal width

Choice D rationale:

Polystyrene sulfonate aims to reduce serum potassium levels. When effective, this should result in a reduction of T-wave amplitude, which is a common ECG change seen with hyperkalemia

In conclusion, choice D is the correct answer, as a reduction in T-wave amplitude would be the expected change on the client's ECG if polystyrene sulfonate effectively lowers their serum potassium level.

A. Distended neck veins. B. Poor skin turgor. C. Concentrated hemoglobin and hematocrit levels. D. Decreased urine output.

Correct Answer is A

Explanation

Choice A rationale:

Fluid volume overload is an excess of fluid in the intravascular and/or interstitial spaces. One of the hallmark signs of fluid volume overload is distended neck veins, which indicates increased venous pressure due to the accumulation of fluid. The neck veins become more visible and prominent, especially when the patient is in a semi-Fowler's position.

Choice B rationale:

Poor skin turgor is a sign of dehydration, not fluid volume overload. It is characterized by the skin's inability to return to its normal position after being gently pinched. In fluid volume overload, the skin may become edematous and puffy, but it does not exhibit poor turgor.

Choice C rationale:

Concentrated hemoglobin and hematocrit levels are seen in conditions of dehydration or hemoconcentration, not in fluid volume overload. In fluid volume overload, there is excess fluid, which may lead to dilutional effects, resulting in decreased concentration of blood components.

Choice D rationale:

Decreased urine output is associated with fluid volume deficit (dehydration) rather than fluid volume overload. In fluid volume overload, there is often an increase in urine output as the body tries to eliminate the excess fluid.

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A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.).

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a serum potassium level of 5.5 mEq/L. The provider prescribes polystyrene sulfonate. If this medication is effective, the nurse should expect which of the following changes on the client's ECG?

Correct Answer is D

Explanation

A postoperative patient is diagnosed with fluid volume overload. What should the nurse expect to assess in this patient?

Correct Answer is A

Explanation

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