Question

The nurse provides care for a client with an ileostomy. For which acid-base disorder does the nurse monitor the client?

1. Metabolic acidosis.
2. Respiratory acidosis.
3. Metabolic alkalosis.
4. Respiratory alkalosis.

Answer 1

A nurse should monitor a client with an ileostomy for metabolic acidosis due to the potential loss of bicarbonate. The kidney may try to compensate, with lab tests indicating the extent of acidosis and compensation.

Step-by-step explanation:

The nurse should monitor the client with an ileostomy for metabolic acidosis. An ileostomy can lead to a loss of a significant amount of bicarbonate because the contents of the small intestine, which are rich in bicarbonate, are diverted from passing through the colon where this bicarbonate would normally be reabsorbed. As a result, the client may experience an excess loss of bicarbonate, leading to a primary decrease in HCO3 levels in the blood and, hence, metabolic acidosis. The kidney may respond by trying to conserve more bicarbonate and secrete more hydrogen ions (H+). The lab tests that can help in diagnosing acid-base imbalances such as pH, CO2 partial pressure (pCO2), and bicarbonate (HCO3-) levels can indicate the presence and extent of metabolic acidosis and any compensatory mechanisms.