A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take first?

Place the client on continuous cardiac monitoring.

Obtain a prescription for insulin for the client.

Plan to administer sodium bicarbonate to the client.

Have the client breathe into a paper bag.

Answer and Explanation

The Correct Answer is A

The correct answer is: A. Place the client on continuous cardiac monitoring.

Choice A reason:

Placing the client on continuous cardiac monitoring is crucial because metabolic alkalosis can lead to life-threatening arrhythmias due to electrolyte imbalances, particularly hypokalemia. Continuous monitoring allows for the early detection and management of these arrhythmias, ensuring patient safety.

Choice B reason:

Obtaining a prescription for insulin is not relevant for treating metabolic alkalosis. Insulin is typically used for managing hyperglycemia and diabetic ketoacidosis, not for correcting alkalosis.

Choice C reason:

Planning to administer sodium bicarbonate is incorrect because sodium bicarbonate is used to treat metabolic acidosis, not alkalosis. Administering it in this context could worsen the alkalosis.

Choice D reason:

Having the client breathe into a paper bag is a technique used for respiratory alkalosis to increase CO2 levels. It is not appropriate for metabolic alkalosis, which requires different management strategies.

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Correct Answer is A

Explanation

Choice A reason: Metabolic alkalosis is a condition in which the blood pH is elevated due to an excess of bicarbonate or a loss of acid. It can be caused by nausea and vomiting, as they result in the loss of gastric acid and the retention of bicarbonate.

Choice B reason: Respiratory acidosis is a condition in which the blood pH is lowered due to an accumulation of carbon dioxide. It can be caused by hypoventilation, airway obstruction, or lung diseases. It is not related to nausea and vomiting.

Choice C reason: Metabolic acidosis is a condition in which the blood pH is lowered due to an excess of acid or a loss of bicarbonate. It can be caused by diabetic ketoacidosis, renal failure, or lactic acidosis. It is not caused by nausea and vomiting.

Choice D reason: Respiratory alkalosis is a condition in which the blood pH is elevated due to a loss
carbon dioxide. It can be caused by hyperventilation, anxiety, fever, or aspirin overdose. It is not common in clients who have nausea and vomiting.

A. Metabolic alkalosis B. Respiratory acidosis C. Respiratory alkalosis D. Metabolic acidosis

Correct Answer is B

Explanation

Choice A reason: Metabolic alkalosis is a condition in which the blood pH is elevated due to an excess of bicarbonate or a loss of acid. It can be caused by vomiting, diuretics, or excessive antacid intake. It is not associated with COPD.

Choice C reason: Respiratory alkalosis is a condition in which the blood pH is elevated due to a loss of carbon dioxide. It can be caused by hyperventilation, anxiety, fever, or aspirin overdose. It is not common in COPD patients.

Choice D reason: Metabolic acidosis is a condition in which the blood pH is lowered due to an excess of acid or a loss of bicarbonate. It can be caused by diabetic ketoacidosis, renal failure, or lactic acidosis. It is not directly related to COPD.

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A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take first?

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