Author Question: A client is admitted with manifestations of metabolic alkalosis. Which diagnostic test findings ... (Read 78 times)

@Brianna17 · **on:** Jun 25, 2018

A client is admitted with manifestations of metabolic alkalosis. Which diagnostic test findings support the admitting diagnosis?

Select all that apply.
A) Serum glucose level 142 mg/dL
B) Blood pH 7.47 and bicarbonate 34 mEq/L
C) Intravenous pyelogram shows kidney stones
D) Bilateral lower lobe infiltrates noted on chest x-ray
E) Electrocardiogram changes consistent with hypokalemia

Question 2

The nurse identifies the diagnosis Risk for Impaired Gas Exchange to guide the care of a client with metabolic alkalosis. Which assessment data supports this nursing diagnosis?

Select all that apply.
A) Respiratory rate 8 per minute
B) Oxygen saturation 89
C) Urine output 25 mL/hr
D) Restlessness and agitation
E) Weight loss of 3 kg overnight

mmpiza · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Answer: B, E
In metabolic alkalosis, the blood pH will be greater than 7.45 and the bicarbonate level greater than 28 mEq/L. The ECG pattern shows changes similar to those seen with hypokalemia. Serum glucose level is not used to confirm the diagnosis of metabolic alkalosis. The presence of kidney stones is not associated with the development of metabolic alkalosis. The presence of bilateral lower lobe infiltrates on chest x-ray would not contribute to the development of metabolic alkalosis. This finding might be the result of metabolic alkalosis if the client's respiratory status is compromised.

Answer to Question 2

Answer: A, B, D

Respiratory compensation for metabolic alkalosis depresses the respiratory rate and reduces the depth of breathing to promote carbon dioxide retention. The depressed respiratory drive associated with metabolic alkalosis can lead to hypoxemia and impaired oxygenation of tissues. Oxygen saturation levels of less than 90 indicate significant oxygenation problems. Changes in mental status or behavior may be early signs of hypoxia. Urine output less than 30 mL/hr would indicate Fluid Volume Deficit. Weight is used as an indicator of fluid balance. A rapid weight change would indicate Fluid Volume Deficit.