The nurse is caring for a patient with metabolic alkalosis. What will the nurse recognize as the common cause of this acid-base imbalance?

Choice A reason: Lethargy and hypoxia are not typically associated with respiratory alkalosis. Respiratory alkalosis occurs when there is excessive exhalation of carbon dioxide, leading to a decrease in blood CO2 levels and an increase in pH. Lethargy and hypoxia are more often related to respiratory acidosis, where CO2 accumulates due to hypoventilation.

Choice B reason: Light-headedness and muscle spasms are common clinical manifestations of respiratory alkalosis. The decrease in carbon dioxide (CO2) levels leads to cerebral vasoconstriction, resulting in light-headedness or dizziness. Additionally, respiratory alkalosis can cause a shift of calcium in the blood, leading to muscle spasms, tingling, and even tetany.

Choice C reason: Hypotension and respiratory depression are not typical findings in respiratory alkalosis. Hypotension can be a symptom of various conditions but is not directly associated with respiratory alkalosis. Respiratory depression is related to hypoventilation and respiratory acidosis, not hyperventilation.

Choice D reason: Muscle twitching and hyperkalaemia are not manifestations of respiratory alkalosis. Hyperkalaemia is more commonly seen in metabolic acidosis and not in respiratory alkalosis. Muscle twitching can occur in various conditions, but respiratory alkalosis typically causes muscle spasms and tetany due to calcium shifts.

Choice A reason: Ketoacidosis is not a typical complication of hyperglycemic hyperosmolar syndrome (HHS) treatment. HHS usually occurs without significant ketoacidosis, and the focus is on managing hyperglycemia and dehydration.

Choice B reason: Pulmonary edema is a potential complication of rapid fluid replacement therapy. The increased fluid volume can overwhelm the heart's ability to pump effectively, leading to fluid accumulation in the lungs.

Choice C reason: Atelectasis is not a common complication of HHS treatment. It is more related to lung collapse or infection rather than fluid or insulin therapy.

Choice D reason: Hypoglycemia is a potential complication of continuous insulin infusion. Close monitoring of blood glucose levels is necessary to prevent blood sugar from dropping too low during treatment.

Choice E reason: Hypokalemia is a potential complication of insulin therapy. Insulin promotes the uptake of potassium into cells, which can reduce serum potassium levels. Monitoring and managing potassium levels is important during HHS treatment.