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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. Calcium gluconate is the antidote for magnesium toxicity; it helps reverse the cardiac and neuromuscular effects of hypermagnesemia.
B. IV fluid restriction is not appropriate; often IV fluids are given to promote magnesium excretion.
C. Potassium chloride is not indicated for hypermagnesemia treatment.
D. Increasing magnesium sulfate would worsen hypermagnesemia and is contraindicated.

Correct Answer is C

Explanation

Rationale:
A. Diarrhea is more common with low calcium (hypocalcemia), while hypercalcemia often causes constipation.
B. Hypercalcemia usually causes hypertension due to increased vascular tone, not hypotension.
C. Elevated calcium levels can depress neuromuscular activity, leading to decreased deep tendon reflexes.
D. Increased appetite is not associated with hypercalcemia; hypercalcemia may cause nausea and decreased appetite.

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