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Exhibits

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

A.

Increased urine output

B.

Loss of gastric secretions

C.

Decreased oral intake

D.

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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Related Questions

Correct Answer is A

Explanation

Rationale:
A. Metabolic acidosis is indicated by a low pH (< 7.35) and low bicarbonate (HCO₃⁻ < 22 mEq/L). The low PaCO₂ (30 mm Hg) suggests respiratory compensation through hyperventilation.
B. Respiratory alkalosis would present with an elevated pH and low PaCO₂, which is not the case here.
C. Respiratory acidosis typically shows high PaCO₂ and low pH; HCO₃⁻ may be elevated if compensation occurs.
D. Metabolic alkalosis would present with a high pH and high HCO₃⁻, which is not consistent with these values.

Correct Answer is D

Explanation

Rationale:
A. Bronchoscopy allows for direct visualization of the airways and may be used for sampling or clearing secretions but does not assess acid-base balance.
B. Pulmonary function tests evaluate lung volume and airflow but are not specific to acid-base status.
C. Pulse oximetry measures oxygen saturation, which reflects oxygenation but not CO₂ levels or pH status.
D. Arterial blood gases (ABGs) are the most accurate test for evaluating acid-base balance, as they provide values for pH, PaCO₂, HCO₃⁻, and PaO₂ — essential indicators in COPD management.

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