After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

"In hot weather, I sweat so much that I drink six glasses of water each day."

"I take sodium bicarbonate after every meal to prevent heartburn."

"I don't drink milk because it gives me gas and diarrhea."

"I have been taking digoxin every day for the last 15 years."

Answer and Explanation

The Correct Answer is B

A. Drinking water in hot weather is important to prevent dehydration. This is not a risk factor for metabolic alkalosis unless the client is excessively losing electrolytes through sweating and not replacing them.

B. Sodium bicarbonate is an alkaline substance, and regular use, especially after meals, can contribute to metabolic alkalosis. The client should be instructed on the potential risks of using sodium bicarbonate too frequently.

C. Avoiding milk due to gastrointestinal symptoms does not directly contribute to metabolic alkalosis.

D. Digoxin does not directly affect acid-base balance, but it requires monitoring due to potential interactions with other medications or electrolyte imbalances.

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Correct Answer is B

Explanation

A. Lantus insulin does not directly affect potassium levels in the same way that digoxin does.

B. A potassium level of 3.0 mEq/L is low, and digoxin toxicity can occur when potassium levels are low, leading to an increased risk of arrhythmias. This requires immediate attention to avoid serious complications.

C. Metoprolol is a beta-blocker that does not directly cause hypokalemia and is less of an immediate concern.

D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that could affect kidney function but does not directly impact potassium levels as significantly as digoxin.

A. Base deficit (HCO3): Acidosis B. Acid excess (CO2): Acidosis C. Base excess (HCO3): Alkalosis D. Acid deficit (CO2): Alkalosis

Correct Answer is B

Explanation

A. Base deficit (HCO3): Acidosis: A base deficit indicates metabolic acidosis, but respiratory acidosis is more likely with the high rate of ventilation.

B. Acid excess (CO2): Acidosis: This is the correct answer. A high respiratory rate can lead to hyperventilation, decreasing CO2 levels and causing respiratory alkalosis, which may be a concern with an elevated rate.

C. Base excess (HCO3): Alkalosis: This would indicate metabolic alkalosis, but it is not as related to ventilator settings.

D. Acid deficit (CO2): Alkalosis: If the CO2 level is too low due to hyperventilation, this can lead to alkalosis, which the nurse is questioning here.

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After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

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Naxlex Comprehensive Predictor Exams

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