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1. Question
A client has experienced 48 hours of severe repeated bouts of vomiting. Which acid-base imbalance is of most concern?
Correct
Option D is the correct answer:
Rationale: Severe vomiting can result in metabolic alkalosis because of loss of chloride in the emesis. In a compensating measure for chloride loss, bicarbonate increases. Metabolic alkalosis may also result from gastric suctioning, diuresis, hypokalemia, and excessive mineralocorticoid or sodium bicarbonate intake. Other laboratory findings include increased pH, normal PCO2 if compensated but increased if noncompensated. Symptoms include dizziness, confusion, anxiety, muscle cramping, tingling, seizures, tetany, tachycardia, arrhythmias, nausea, vomiting, anorexia, and compensatory hypoventilation.
Incorrect
Option D is the correct answer:
Rationale: Severe vomiting can result in metabolic alkalosis because of loss of chloride in the emesis. In a compensating measure for chloride loss, bicarbonate increases. Metabolic alkalosis may also result from gastric suctioning, diuresis, hypokalemia, and excessive mineralocorticoid or sodium bicarbonate intake. Other laboratory findings include increased pH, normal PCO2 if compensated but increased if noncompensated. Symptoms include dizziness, confusion, anxiety, muscle cramping, tingling, seizures, tetany, tachycardia, arrhythmias, nausea, vomiting, anorexia, and compensatory hypoventilation.
Alkalosis: an acid–base imbalance characterized by a reduction in H+ concentration (increased blood pH). A high arterial pH with increased bicarbonate concentration is called metabolic alkalosis; a high arterial pH due to reduced PCO2 is respiratory alkalosis.
