A client with metabolic alkalosis is experiencing numbness around ...

[jman1234]

A client with metabolic alkalosis is experiencing numbness around the mouth and tingling of the fingers. What should the nurse explain as the reason for these manifestations?
 
  A) Because you are breathing so fast, the oxygen is not getting to your nerve endings.
  B) Your health problem affects calcium in your body, which causes the tingling around your mouth and fingers.
  C) You have a build-up of carbon dioxide in your blood.
  D) You don't have enough potassium in your body, so the tingling around your mouth and fingers will occur.

Question 2

A client with terminal colon cancer is refusing all food and fluids. The client has a living will that states no artificial nutrition is to be provided; however, the family is asking for a gastrostomy tube. What should the nurse do?
 
  A) Take the case to the hospital's ethics committee.
  B) Talk to the physician so he or she can move forward with the family's wishes.
  C) Honor the client's refusal and help the family come to terms with the situation.
  D) Honor the family's wishes and have them sign a consent form.

[morrie123456]

Answer to Question 1

Answer: B

Alkalosis increases binding of extracellular calcium to albumin, reducing ionized calcium levels. As a result, neuromuscular excitability increases, and manifestations similar to hypocalcemia develop. These manifestations include circumoral and distal extremity paresthesias. Rapid breathing is not reducing the amount of oxygen reaching the nerve endings. Excessive carbon dioxide would lead to acidosis. Respiratory alkalosis is not caused by an imbalance of serum potassium.

Answer to Question 2

Answer: C

A nurse is morally obligated to withhold food and fluids if it is determined to be more harmful to administer them than to withhold them. The nurse must also honor competent clients' refusal of food and fluids. This position is supported by the ANA's Code of Ethics for Nurses, through the nurse's role as a client advocate and through the moral principle of autonomy. Clients, not their families, should make decisions about their own health care and treatment. The physician may or may not be involved, but would not disregard the client's refusal. An ethics committee is usually considered when there is an ethical dilemma and more input is needed to make a decision. In this case, the client has made a decision and it should be honored.

[jman1234]

Correct answers!

[morrie123456]

Great! Please up vote