Use the scenario to guide your answer

Exhibits

What is the primary reason for electrolyte loss in a patient with an NG tube to suction?

Increased urine output

Loss of gastric secretions

Decreased oral intake

Fever

Answer and Explanation

The Correct Answer is B

Rationale:

A. Increased urine output: Mr. Allen's urine output is actually low (600 mL/24 hrs), and his urine is dark and concentrated, suggesting dehydration, not excessive urinary losses.

B. Loss of gastric secretions: Continuous suction via the nasogastric (NG) tube removes gastric fluids, which are rich in potassium, chloride, hydrogen ions, and magnesium. This is the main reason for his observed hypokalemia (K = 2.9), hypochloremia (Cl = 94), and low magnesium (Mg = 1.2).

C. Decreased oral intake: While Mr. Allen is NPO, reduced intake alone is not sufficient to cause such significant electrolyte imbalances in a short period. The active loss of electrolytes through NG suction is the primary contributor.

D. Fever is not mentioned in the scenario. Fever can lead to insensible fluid losses, but this is not relevant here and not the primary mechanism of electrolyte depletion.

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Correct Answer is A

Explanation

Rationale:
A. Respiratory acidosis results from hypoventilation (respiratory rate of 6 breaths/min), leading to CO₂ retention and decreased blood pH. Cyanosis also indicates poor oxygenation, supporting this diagnosis.
B. Metabolic acidosis typically results from renal failure, diarrhea, or diabetic ketoacidosis, not directly from low respiratory rate.
C. Respiratory alkalosis is caused by hyperventilation, not hypoventilation.
D. Metabolic alkalosis is usually caused by vomiting or diuretic use and is not associated with decreased respiratory rate or cyanosis.

A. Introduce a regular diet B. Rehydrate. C. Maintain fluid therapy. D. Assess fluid balance.

Correct Answer is B

Explanation

Rationale:
A. Introducing a regular diet is important but not the immediate priority in severe diarrhea.
B. Rehydration is the most critical initial step to prevent or treat dehydration and shock.
C. Maintaining fluid therapy is important after rehydration is initiated but not the first action.
D. Assessing fluid balance is necessary but secondary to initiating rehydration.

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Use the scenario to guide your answer Exhibits What is the primary reason for electrolyte loss in a patient with an NG tube to suction?

Rationale:

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Explanation

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Use the scenario to guide your answer

Exhibits

What is the primary reason for electrolyte loss in a patient with an NG tube to suction?