A nurse is caring for a patient with metabolic alkalosis.
What actions should the nurse take?
A.
Place the patient on continuous cardiac monitoring.
B.
Obtain a prescription for insulin for the patient.
C.
Plan to administer sodium bicarbonate to the patient.
D.
Have the patient breathe into a paper bag.
The Correct Answer and Explanation is:
The correct answer is D. Have the patient breathe into a paper bag.
Explanation:
Metabolic alkalosis is a condition characterized by an elevated blood pH and an increased bicarbonate (HCO₃⁻) level due to an underlying issue that typically causes a loss of hydrogen ions (H⁺) or an excess of bicarbonate. Common causes include prolonged vomiting, diuretic use, or an overuse of antacids.
Here’s a breakdown of why option D is the correct response and why the other options are less appropriate:
D. Have the patient breathe into a paper bag:
In metabolic alkalosis, the patient’s respiratory rate may be low as a compensatory mechanism to retain CO₂, which helps in lowering the blood pH. Breathing into a paper bag can help the patient re-breathe CO₂, which temporarily increases CO₂ levels in the blood and can help counteract the alkalosis by decreasing the blood pH towards normal. This method is a simple and effective way to manage the symptoms of alkalosis until more specific treatment is administered.
A. Place the patient on continuous cardiac monitoring:
While continuous cardiac monitoring is generally important for patients with severe electrolyte imbalances or cardiovascular issues, it is not specifically indicated for metabolic alkalosis unless there are associated complications like arrhythmias. The primary treatment for metabolic alkalosis involves correcting the underlying cause and managing symptoms, not necessarily cardiac monitoring unless indicated.
B. Obtain a prescription for insulin for the patient:
Insulin administration is not relevant for metabolic alkalosis. Insulin is primarily used for managing hyperglycemia in diabetic patients. Metabolic alkalosis does not typically involve blood glucose imbalances that would require insulin therapy.
C. Plan to administer sodium bicarbonate to the patient:
Administering sodium bicarbonate would be counterproductive in the case of metabolic alkalosis. Sodium bicarbonate is used to treat metabolic acidosis, not alkalosis. Adding more bicarbonate would exacerbate the alkalosis.
Therefore, the most appropriate action is to have the patient breathe into a paper bag to help alleviate the symptoms of metabolic alkalosis by temporarily increasing CO₂ levels. This, combined with addressing the underlying cause of the alkalosis, will help manage the condition effectively.