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Question

Difficulty: EasyPhysiological Adaptation

During a clinic visit, a client reports continuous, severe vomiting over the last two days due to a gastrointestinal illness. The nurse anticipates that this prolonged loss of gastric secretions places the client at highest risk for which acid-base imbalance?

  1. Metabolic alkalosisAnswer
  2. B
    Metabolic acidosis
  3. C
    Respiratory alkalosis
  4. D
    Respiratory acidosis

Answer

Metabolic alkalosis
The correct answer is metabolic alkalosis because prolonged vomiting depletes the body of gastric acid (hydrochloric acid). The significant loss of hydrogen ions causes a compensatory increase in systemic blood pH and bicarbonate levels, leading to a metabolic alkaline state. This is a fundamental physiological adaptation to upper gastrointestinal fluid loss.

Step-by-Step Solution

1
Identify the primary source and mechanism of fluid loss.
The client is experiencing severe, continuous vomiting.
Determining the route of fluid loss is the first step in predicting the associated physiological disruption.
2
Analyze the chemical composition of the lost fluid.
Stomach secretions are highly acidic because they contain large amounts of hydrochloric acid.
Understanding what electrolytes and ions are being depleted helps identify the specific acid-base shift.
3
Determine the resulting systemic imbalance.
The massive loss of hydrogen ions (acid) from the stomach leaves the blood with a relative excess of base (bicarbonate).
A decrease in systemic hydrogen ions directly increases blood pH, defining the state as metabolic alkalosis.

Key Concept

Acid-Base Imbalances related to Gastrointestinal Fluid Loss
Estimated Time:45s
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Topics

Physiological Adaptation

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