The patient is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma. The nurse assesses cyanosis, slow respirations, and irregular pulse. What is the nurse's priority action?
1. Increase the rate of the infusion and continue to assess the patient for symptoms of acidosis.
2. Decrease the rate of the infusion and continue to assess the patient for symptoms of alkalosis.
3. Continue the infusion; the patient is still in acidosis.
4. Stop the infusion and notify the physician; the patient is in alkalosis.
Correct Answer: 4
Rationale: The patient receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The patient's symptoms indicate alkalosis so infusion must be stopped and the physician notified. The patient is not in acidosis, symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The patient is not in acidosis, so the infusion must be stopped, not increased. The infusion must be stopped, not decreased, as the patient is in alkalosis.
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