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Difficulty: EasyPhysiological Adaptation

A client is receiving continuous gastric suctioning via a nasogastric tube following abdominal surgery. Based on the physiological loss of gastric secretions, which acid-base imbalance should the nurse monitor for in this client?

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

Answer

Metabolic alkalosis is the correct acid-base imbalance to monitor for in this scenario.
Gastric secretions contain a high amount of hydrochloric acid. When these secretions are continuously removed from the body via a nasogastric tube, the body loses a significant amount of hydrogen ions. This direct loss of acid causes a relative increase in circulating blood bicarbonate levels, shifting the body's pH upward and resulting in metabolic alkalosis.

Step-by-Step Solution

1
Identify the primary physiological fluid being lost.
The client is losing significant amounts of gastric secretions through continuous nasogastric suctioning.
Determining the source and type of fluid loss is necessary to understand which electrolytes and acids or bases are being depleted from the body.
2
Determine the acid-base composition of the lost fluid.
Gastric fluid contains a high concentration of hydrochloric acid.
Knowing the chemical composition of the fluid helps predict the resulting systemic imbalance.
3
Deduce the systemic effect of losing this fluid.
Losing acid from the body leaves a relative excess of base (bicarbonate) in the bloodstream, leading to metabolic alkalosis.
The body's pH shifts toward an alkalotic state when significant amounts of acid are physically removed through the gastrointestinal tract.

Key Concept

Acid-Base Imbalances: Gastrointestinal Fluid Loss
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Topics

Physiological Adaptation

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