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

Chronic renal disease

Prolonged vomiting

Hyperventilation

Obstructive sleep apnea

Answer and Explanation

The Correct Answer is B

Choice A reason: Chronic renal disease typically leads to metabolic acidosis, not alkalosis, due to the accumulation of acids that the kidney cannot excrete.

Choice B reason: Prolonged vomiting leads to the loss of hydrochloric acid from the stomach, which can result in metabolic alkalosis due to the imbalance caused by the loss of stomach acid.

Choice C reason: Hyperventilation leads to respiratory alkalosis due to the excessive exhalation of carbon dioxide, reducing hydrogen ion concentration in the blood.

Choice D reason: Obstructive sleep apnea is typically associated with respiratory acidosis, not metabolic alkalosis, due to episodes of hypoventilation during sleep.

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Correct Answer is B

Explanation

Choice A reason: Starting with a rapid infusion rate to meet the patient's nutritional needs as quickly as possible is not recommended. Rapid infusion can cause complications such as fluid overload, hyperglycemia, and electrolyte imbalances. It is important to start TPN at a slow rate and gradually increase it as tolerated.

Choice B reason: Initiating the infusion slowly and monitoring the patient's fluid and glucose tolerance is the appropriate action. This allows the nurse to assess the patient's response to TPN, prevent complications, and make necessary adjustments to the infusion rate.

Choice C reason: Changing the rate of administration every 4 hours based on serum electrolyte values is not a standard practice. The rate should be adjusted based on the patient's overall tolerance and clinical condition, rather than frequent changes.

Choice D reason: Increasing the rate of infusion at mealtimes to mimic the circadian rhythm of the body is not appropriate for TPN. TPN is typically administered continuously over 24 hours to provide steady nutrition and prevent complications.

A. Respiratory alkalosis, uncompensated B. Respiratory acidosis, partially compensated C. Metabolic acidosis, uncompensated D. Metabolic alkalosis, partially compensated

Correct Answer is D

Explanation

Choice A reason: Respiratory alkalosis with uncompensated imbalance would show a low PaCO2, not a normal value.

Choice B reason: Respiratory acidosis with partially compensated imbalance would show a low pH and high PaCO2 with an elevated bicarbonate level.

Choice C reason: Metabolic acidosis with uncompensated imbalance would show a low pH and low bicarbonate level.

Choice D reason: Metabolic alkalosis with partially compensated imbalance is indicated by the elevated pH and bicarbonate level, while

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