Medical Surgical ABGs & Acid Base Imbalances #1

Question

The nurse is caring for a bulimic client who abuses laxatives. The nurse will monitor the client for which acid-base illness?

Answers

  1. Metabolic alkalosis
    • Rationale:

      This answer is not correct because the diarrhea associated with the abuse of laxatives results in loss of alkaline, causing the body to become more acidic. Metabolic alkalosis happens when the body becomes overly alkaline, such as from diuretic use, gastrointestinal suctioning, or vomiting.

  2. Metabolic acidosis
    • Rationale:

      This answer is correct because the body loses too much alkali from severe diarrhea, resulting in the body retaining too much acid. This is called metabolic acidosis. The pH is less than 7.35 and the HCO3 level is less than 20.

  3. Respiratory alkalosis
    • Rationale:

      This answer is not correct because respiratory alkalosis is when the pH of the blood rises and becomes too alkaline. Causes of respiratory alkalosis include hyperventilation, hypoxia, or anxiety.

  4. Respiratory acidosis
    • Rationale:

      This answer is not correct because respiratory acidosis is when the lungs cannot remove enough carbon dioxide, which causes the pH of the blood to decrease, becoming too acidic. Causes of respiratory acidosis are asthma, pneumonia, and pulmonary edema.

Overview

A client with bulimia who purges and uses laxatives is at risk for metabolic acidosis. Severe diarrhea leads to great loss of base since intestinal secretions are usually alkaline. Malnutrition results in a buildup of excess ketones and acids.

Explanation

Learning Outcomes

Metabolic acidosis occurs when the body loses an excess of alkali and retains too much acid as a result. The pH is less than 7.35 and the HCO3 level is less than 20. Severe diarrhea is one way for the body to enter into metabolic acidosis. Other risk factors include diabetic ketoacidosis, malnutrition, and renal insufficiency. Metabolic alkalosis happens when the body becomes overly alkaline, such as from diuretic use, gastrointestinal suctioning, or vomiting. Respiratory alkalosis is when the pH of the blood rises and becomes too alkaline. Causes of respiratory alkalosis include hyperventilation, hypoxia, or anxiety. Respiratory acidosis is when the lungs cannot remove enough carbon dioxide, which causes the pH of the blood to decrease, becoming too acidic. Causes of respiratory acidosis are asthma, pneumonia, and pulmonary edema.

Test Taking Tip

Acidosis is too much acid in the body. Alkalosis is too much alkaline in the body. Think about these in relation to metabolism and respiratory. A client with severe diarrhea is losing alkaline through their metabolism. So, this is metabolic acidosis.

Video Rationale