The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for?
A.
Respiratory acidosis
B.
Metabolic acidosis
C.
Respiratory alkalosis
D.
Metabolic alkalosis
The Correct answer and Explanation is:
The correct answer is D. Metabolic alkalosis.
Explanation:
Clients with a nasogastric (NG) tube attached to low suction are at risk for developing metabolic alkalosis, primarily due to the loss of gastric contents. The stomach produces gastric acid (hydrochloric acid), which contains hydrogen ions (H+). When a nasogastric tube is used for suction, especially over a prolonged period, there is a significant loss of these gastric secretions, leading to a decrease in the body’s hydrogen ion concentration.
Metabolic alkalosis occurs when there is an increase in bicarbonate (HCO3-) or a loss of hydrogen ions, leading to an elevated pH. In this case, the suctioning of gastric contents removes hydrochloric acid from the stomach, resulting in a relative increase in bicarbonate. This loss is compounded if the client is unable to maintain adequate fluid intake or if there is any additional loss of hydrogen ions, such as through vomiting or excessive diuretic use.
Clinical manifestations of metabolic alkalosis can include symptoms like muscle twitching, hand tremors, and tingling in the extremities or around the mouth, which are due to the decreased ionized calcium levels that accompany alkalosis. The nurse should be vigilant in monitoring the client for these signs, as well as assessing vital signs and electrolytes, particularly potassium levels, which can also drop as a result of metabolic alkalosis.
In contrast, respiratory acidosis (A) and respiratory alkalosis (C) are primarily related to issues with carbon dioxide retention or loss due to changes in respiratory function, which are not directly associated with NG suctioning. Metabolic acidosis (B) usually occurs due to conditions that increase acid production or decrease acid excretion, which are also not directly related to NG tube suctioning.
In summary, the risk of metabolic alkalosis in clients with NG tubes on suction necessitates careful monitoring and proactive management of their fluid and electrolyte balance.