Which acid-base disorder should be monitored in a client with bowel obstructions?

Which acid-base disorder should be monitored in a client with bowel obstructions?

• A. Metabolic acidosis
• B. Respiratory alkalosis
• C. Metabolic alkalosis
• D. Respiratory acidosis

Answer: (C)

Loss of gastric acid from vomiting, which commonly occurs with bowel obstruction, leads to metabolic alkalosis. When hydrogen ions and chloride are lost in the vomitus, the remaining bicarbonate in the blood rises, increasing the pH. The body may try to compensate by adjusting ventilation, but dehydration and reduced kidney perfusion from the obstruction can limit bicarbonate excretion and sustain the alkalosis. Clinically, this pattern is often accompanied by low chloride and potassium, which can perpetuate the alkalosis and guide treatment with fluids that include chloride. This scenario is not driven by CO2 changes from warming or cooling breaths (respiratory disorders) nor by bicarbonate loss or excess from other GI losses in a way that would produce metabolic acidosis, so the relevant disturbance to monitor in bowel obstruction is metabolic alkalosis.

Loss of gastric acid from vomiting, which commonly occurs with bowel obstruction, leads to metabolic alkalosis. When hydrogen ions and chloride are lost in the vomitus, the remaining bicarbonate in the blood rises, increasing the pH. The body may try to compensate by adjusting ventilation, but dehydration and reduced kidney perfusion from the obstruction can limit bicarbonate excretion and sustain the alkalosis. Clinically, this pattern is often accompanied by low chloride and potassium, which can perpetuate the alkalosis and guide treatment with fluids that include chloride. This scenario is not driven by CO2 changes from warming or cooling breaths (respiratory disorders) nor by bicarbonate loss or excess from other GI losses in a way that would produce metabolic acidosis, so the relevant disturbance to monitor in bowel obstruction is metabolic alkalosis.