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
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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Related Questions
Correct Answer is C
Explanation
PacO2 50 mm Hg. Choice A rationale:
Potassium levels are not directly related to respiratory acidosis. Potassium levels may be affected in certain conditions, but they are not specific indicators of respiratory acidosis.
Choice B rationale:
HCO3- (bicarbonate) levels may be elevated in metabolic alkalosis, not respiratory acidosis. In respiratory acidosis, the primary abnormality is an increased PacO2, not HCO3-.
Choice C rationale:
The partial pressure of carbon dioxide (PacO2) is a key parameter in diagnosing respiratory acidosis. In this case, a PacO2 of 50 mm Hg suggests hypoventilation and an excess of carbon dioxide in the blood, contributing to acidosis.
Choice D rationale:
The pH level given (pH 7.45) is within the normal range, which contradicts the diagnosis of respiratory acidosis. In respiratory acidosis, the pH would be expected to be below the normal range of 7.35-7.45 due to increased carbon dioxide levels.
Correct Answer is A
Explanation
Sodium 155 mEq/L. Choice A rationale:
A urine specific gravity of 1.035 indicates concentrated urine and is consistent with fluid volume deficit. However, it is not the most specific finding for this condition.
Choice B rationale:
A BUN (blood urea nitrogen) level of 19 mg/dL can be a normal value. It is within the reference range (usually around 7-20 mg/dL) and does not provide specific information about fluid volume deficit.
Choice C rationale:
A hematocrit of 44.9% can also be within the normal range for some individuals, and while it can be elevated in cases of fluid volume deficit, it is not as sensitive as other parameters for detecting this condition.
Choice D rationale:
This is the correct answer because a sodium level of 155 mEq/L is elevated and indicates hypernatremia, which is associated with fluid volume deficit. Hypernatremia occurs when there is a relative lack of water in relation to the sodium concentration in the blood, and it can lead to dehydration
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