After providing discharge teaching, a nurse assesses the patient’s understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the patient needs additional teaching?

Choice A reason: Drinking six glasses of water in hot weather prevents dehydration but does not directly cause metabolic alkalosis. Excessive sweating may lead to volume depletion, but adequate hydration maintains electrolyte balance, making this statement appropriate and not indicative of a need for further teaching. Choice B reason: Taking sodium bicarbonate after every meal increases bicarbonate intake, raising blood pH and causing metabolic alkalosis. This excessive base load overwhelms renal compensation, leading to alkalemia, which can cause symptoms like confusion or arrhythmias, indicating a need for teaching to avoid overuse of antacids. Choice C reason: Avoiding milk due to gas and diarrhea suggests lactose intolerance, which does not contribute to metabolic alkalosis. This dietary choice prevents gastrointestinal distress but has no direct impact on acid-base balance, making it an appropriate statement not requiring additional teaching. Choice D reason: Taking digoxin daily for 15 years is unrelated to metabolic alkalosis, as it treats heart conditions without affecting acid-base balance. While digoxin toxicity can cause other issues, this statement does not indicate a misunderstanding of alkalosis risk, requiring no further teaching on this topic.