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Difficulty: EasyPhysiological Adaptation

An adult client who has been experiencing intractable vomiting for the last 72 hours is admitted to the medical-surgical unit. Based on the significant loss of gastric contents, which acid-base disturbance should the nurse most anticipate when reviewing the client's laboratory results?

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

Answer

Metabolic alkalosis
Prolonged vomiting causes a severe depletion of gastric secretions, which are rich in hydrochloric acid. The continuous loss of these hydrogen ions from the body leaves a relative excess of circulating bicarbonate. This imbalance raises the systemic pH and directly results in metabolic alkalosis as a physiological adaptation.

Step-by-Step Solution

1
Analyze the clinical scenario for the primary mechanism of fluid or electrolyte loss.
The client has experienced prolonged vomiting, leading to a significant loss of gastric secretions.
Identifying the specific source and nature of volume loss is the crucial first step in predicting subsequent acid-base changes.
2
Determine the chemical composition of the lost gastrointestinal fluids.
Gastric fluid is highly acidic due to the presence of large amounts of hydrochloric acid.
Understanding the pH and composition of the lost fluids explains how the systemic balance will shift.
3
Predict the resulting systemic physiological adaptation and imbalance.
The extensive loss of systemic acid leaves a relative excess of bicarbonate, elevating the blood pH and causing metabolic alkalosis.
A primary deficit of hydrogen ions directly tips the acid-base balance toward an alkaline state.

Key Concept

Acid-Base Imbalances: Metabolic Alkalosis from Gastric Acid Loss
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Topics

Physiological Adaptation

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