Final answer:
Significant vomiting or NGT suctioning typically leads to metabolic alkalosis due to the loss of stomach acids. This is indicated by increased blood pH levels and can be diagnosed through lab tests measuring pH, pCO2, and HCO3.
Step-by-step explanation:
The classic acid-base findings related to significant vomiting or NGT (nasogastric tube) suctioning typically include metabolic alkalosis.
This occurs due to the excessive loss of hydrochloric acid (HCl) from the stomach. When a patient experiences severe vomiting or undergoes NGT suctioning, hydrogen and chloride ions, which are components of gastric acid, are lost. This leads to an increase in blood pH, indicative of alkalosis. To provide a better understanding:
If prolonged vomiting or NGT suctioning occurs, there is a loss of digestive fluid rich in hydrogen and chloride ions, which contributes to metabolic alkalosis.
Hypochloremia (low levels of chloride in the blood) can also contribute to the development of metabolic alkalosis, which may also occur in conditions like Cushing's syndrome or following the administration of ACTH or cortisone.
Lab tests such as blood pH, CO2 partial pressure (pCO2), and bicarbonate (HCO3) levels can identify whether an individual has acidosis or alkalosis, and whether the cause is respiratory or metabolic. Compensation mechanisms can be detected by these values.
For instance, in the case of Kim, who has a history of bulimia with a blood pH of 7.48, normal pCO2, and elevated HCO3, we would classify her acid-base balance as metabolic alkalosis with no evident respiratory compensation, as her pCO2 is normal. Bulimia can contribute to this lab result via frequent vomiting leading to HCl loss.
Meanwhile, Bob, with asthma, has a blood pH of 7.31, elevated pCO2, and elevated HCO3, indicating respiratory acidosis with metabolic compensation, as his body attempts to retain bicarbonate to offset the reduced pH.