A nurse assesses a client who is receiving total parenteral ...

[Kikoku]

A nurse assesses a client who is receiving total parenteral nutrition. For which adverse effects related to an acid-base imbalance should the nurse assess? (Select all that apply.)
 
  a. Positive Chvostek's sign
  b. Elevated blood pressure
  c. Bradycardia
  d. Increased muscle strength
  e. Anxiety and irritability

Question 2

A nurse assesses a client who is experiencing an acid-base imbalance. The client's arterial blood gas values are pH 7.32, PaO2 94 mm Hg, PaCO2 34 mm Hg, and HCO3- 18 mEq/L. For which clinical manifestations should the nurse assess? (Select all that apply.
 
  a. Reduced deep tendon reflexes
  b. Drowsiness
  c. Increased respiratory rate
  d. Decreased urinary output
  e. Positive Trousseau's sign

[gabrielle_lawrence]

Answer to Question 1

ANS: A, E
A client receiving total parenteral nutrition is at risk for metabolic alkalosis. Manifestations of metabolic alkalosis include positive Chvostek's sign, normal or low blood pressure, increased heart rate, skeletal muscle weakness, and anxiety and irritability.

Answer to Question 2

ANS: A, B, C
Metabolic acidosis causes neuromuscular changes, including reduced muscle tone and deep tendon reflexes. Clients usually present with lethargy and drowsiness. The respiratory system will attempt to compensate for the metabolic acidosis; therefore, respirations will increase rate and depth. A positive Trousseau's sign is associated with alkalosis. Decreased urine output is not a manifestation of metabolic acidosis.

[Kikoku]

TYSM

[Sarahjh]

Excellent