A patient has taken an overdose of aspirin. Which of the following should a nurse must closely monitor for during acute management of this patient?
A. Onset of pulmonary edema
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Parkinson’s disease type symptoms
Correct Answer: A. Onset of pulmonary edema
Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development. Early symptoms of aspirin poisoning also include tinnitus, hyperventilation, vomiting, dehydration, and fever. Late signs include drowsiness, bizarre behavior, unsteady walking, and coma. Abnormal breathing caused by aspirin poisoning is usually rapid and deep. Pulmonary edema may be related to an increase in permeability within the capillaries of the lung leading to “protein leakage” and transudation of fluid in both renal and pulmonary tissues. The alteration in renal tubule permeability may lead to a change in colloid osmotic pressure and thus facilitate pulmonary edema (via Medscape).
Option B: Aspirin overdose causes metabolic acidosis, not alkalosis. Metabolic alkalosis is a primary increase in serum bicarbonate (HCO3 -) concentration.
Option C: Respiratory alkalosis is a disturbance in acid and base balance due to alveolar hyperventilation.
Option D: Parkinson’s type symptoms include tremors, bradykinesia, rigid muscles, impaired posture and balance, speech changes, and loss of automatic movements.