Vomiting of stomach contents or continuous nasogastric suctioning may predispose to the development of:
Metabolic acid deficit (metabolic alkalosis)
Carbonic acid excess (respiratory acidosis)
Metabolic acid excess (metabolic acidosis)
Carbonic acid deficit (respiratory alkalosis)
The Correct Answer is A
Choice A: Metabolic Acid Deficit (Metabolic Alkalosis)
Vomiting or continuous nasogastric suctioning leads to the loss of gastric contents, which are rich in hydrochloric acid (HCl)1. This loss results in a decrease in the body’s acid levels, leading to a condition known as metabolic alkalosis2. Metabolic alkalosis is characterized by an increase in blood pH due to the loss of hydrogen ions (H+) and an increase in bicarbonate (HCO3-) levels. This condition can cause symptoms such as muscle twitching, hand tremors, and light-headedness.
Choice B: Carbonic Acid Excess (Respiratory Acidosis)
Carbonic acid excess, or respiratory acidosis, occurs when there is an accumulation of carbon dioxide (CO2) in the blood, leading to a decrease in blood pH3. This condition is typically caused by respiratory issues such as hypoventilation, chronic obstructive pulmonary disease (COPD), or severe asthma. It is not directly related to vomiting or nasogastric suctioning, which primarily affect the metabolic component of acid-base balance.
Choice C: Metabolic Acid Excess (Metabolic Acidosis)
Metabolic acidosis is characterized by a decrease in blood pH due to an accumulation of metabolic acids or a loss of bicarbonate. Common causes include renal failure, diabetic ketoacidosis, and severe diarrhea. Vomiting or nasogastric suctioning, which result in the loss of gastric acid, do not lead to metabolic acidosis but rather to metabolic alkalosis.
Choice D: Carbonic Acid Deficit (Respiratory Alkalosis)
Respiratory alkalosis occurs when there is a decrease in carbon dioxide levels in the blood, leading to an increase in blood pH. This condition is often caused by hyperventilation due to anxiety, fever, or high altitude. It is not related to the loss of gastric contents through vomiting or nasogastric suctioning, which primarily affect the metabolic component of acid-base balance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: Alkalosis
Alkalosis refers to a condition where the blood pH is higher than the normal range (above 7.45). In this case, the pH is 7.25, which indicates an acidic environment rather than an alkaline one. Therefore, alkalosis is not the correct answer.
Choice B: Respiratory
Respiratory acidosis or alkalosis is determined by the levels of PaCO2. In respiratory acidosis, PaCO2 is elevated, while in respiratory alkalosis, PaCO2 is decreased. Here, the PaCO2 is 20 mm Hg, which is below the normal range, indicating a respiratory component. However, the primary issue is not respiratory because the HCO3- is also significantly low, pointing towards a metabolic cause.
Choice C: Metabolic
Metabolic acidosis is characterized by a low pH and a low HCO3- level. In this case, the pH is 7.25, and the HCO3- is 10 mEq/L, both of which are below the normal ranges. This indicates that the primary acid-base imbalance is metabolic acidosis.
Choice D: Acidosis
Acidosis refers to a condition where the blood pH is lower than the normal range (below 7.35). The given pH of 7.25 confirms that the patient is experiencing acidosis. However, this choice alone does not specify whether it is metabolic or respiratory acidosis.
Choice E: With Compensation (Being Compensated)
Compensation refers to the body’s attempt to return the pH to normal by adjusting the levels of PaCO2 or HCO3-. In this case, the low PaCO2 suggests that there is a respiratory compensation for the metabolic acidosis. However, the primary imbalance remains metabolic acidosis.
Correct Answer is B
Explanation
Choice A Reason:
Disease treatment refers to the management and care of a patient to combat a disease or condition. This includes interventions aimed at curing the disease, alleviating symptoms, or preventing complications. While physical therapy can be part of disease treatment, in the context of a heart attack, it is more accurately described as a form of tertiary prevention.
Choice B Reason:
Tertiary prevention involves measures taken to reduce the impact of an ongoing illness or injury that has lasting effects. This includes rehabilitation and efforts to prevent further complications or deterioration. Physical therapy after a heart attack is a classic example of tertiary prevention, as it aims to improve the patient’s quality of life, enhance physical function, and prevent further cardiac events.
Choice C Reason:
Secondary prevention focuses on early detection and prompt intervention to prevent the progression of a disease. This includes screening tests and early treatment of conditions to halt or slow their progression. In the case of heart disease, secondary prevention might involve regular monitoring of blood pressure and cholesterol levels to detect and manage risk factors early.
Choice D Reason:
Primary prevention aims to prevent the onset of disease before it occurs by reducing risk factors and promoting healthy behaviors. This includes lifestyle changes such as a healthy diet, regular exercise, and smoking cessation to prevent the development of heart disease in the first place. Physical therapy after a heart attack does not fall under primary prevention, as it is an intervention after the disease has already occurred.
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