A student nurse is working with their preceptor on a medical-surgical unit. While reviewing concepts related to acid-base balance, what should the preceptor state is a compensatory mechanism for metabolic alkalosis?
Kidney conservation of bicarbonate and excretion of hydrogen ions
Deep, rapid respirations to increase CO2 excretion
Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate
Shifting of bicarbonate into cells in exchange for chloride
The Correct Answer is C
A. Kidney conservation of bicarbonate and excretion of hydrogen ions: This option is not correct for metabolic alkalosis. In metabolic alkalosis, the kidneys would typically excrete bicarbonate rather than conserve it.
B. Deep, rapid respirations to increase CO2 excretion: This is incorrect because deep, rapid respirations are more associated with compensating for metabolic acidosis by increasing CO2 excretion. In metabolic alkalosis, the body attempts to retain CO2.
C. Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate: This is the correct choice. In metabolic alkalosis, the body compensates by reducing respiration rate (hypoventilation) to retain CO2, which helps to counteract the elevated pH. Additionally, the kidneys may excrete bicarbonate to balance the pH.
D. Shifting of bicarbonate into cells in exchange for chloride: This mechanism is more related to respiratory alkalosis rather than metabolic alkalosis. In metabolic alkalosis, the primary compensatory mechanisms involve changes in respiratory rate and renal bicarbonate excretion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Serum potassium 5.0 mEq/L: This is within the normal range for serum potassium (3.5-5.0 mEq/L). While potassium levels are important, they are not the primary concern with symptoms of confusion and a bounding pulse due to excessive water intake.
B. Serum osmolality 294 mmol/kg: This value is within the normal range for serum osmolality (275-295 mmol/kg). Elevated or normal osmolality would not be expected in a case of water intoxication, which dilutes serum electrolytes.
C. Serum sodium of 127 mEq/L: A serum sodium level of 127 mEq/L indicates hyponatremia, a condition often caused by excessive water intake that dilutes the sodium in the bloodstream. Symptoms such as confusion, headache, and a full bounding pulse are consistent with hyponatremia, making this the expected abnormality.
D. Serum hemoglobin 15.7 grams/dL: This is within the normal range for hemoglobin (12-16 grams/dL for women and 13.8-17.2 grams/dL for men). Hemoglobin levels would not be expected to change significantly due to water intoxication.
Correct Answer is C
Explanation
A. Crush the medication and administer it through the tube: Crushing sustained-release medications can alter their release mechanism, leading to potential overdose or ineffective treatment. Sustained-release formulations should not be crushed.
B. Provide the medication orally for the client to swallow: This option is not appropriate because the client has a gastrostomy tube, and oral administration is not suitable for this route.
C. Ask the healthcare provider to prescribe the medication as an elixir for tube administration: This is the correct approach as it ensures the medication is in a form suitable for administration through the gastrostomy tube without altering its release properties.
D. Dissolve the medication in water and administer it through the tube: Dissolving sustained-release tablets is not recommended as it may compromise the medication's intended release mechanism.
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