Question

A male client is admitted with a bowel obstruction and intractable vomiting for the past several hours despite the use of antiemetics. w\Which intervention should the nurse implement first?

Labs:
pH = 7.50
PaCO2 = 42 mmHg
HCO3 = 33 mEq/L
pO2 = 92 mmHg
A) Document strict intake and output
B) Infuse 0.9% nacl 500 mL bolus
C) Insert nasogastric tube to intermittent suction.
D) Maintain head of bed at 45 degrees

Answer 1

For a client with a bowel obstruction and intractable vomiting showing signs of metabolic alkalosis, the priority intervention is to insert a nasogastric tube to intermittent suction.

Step-by-step explanation:

The main answer for a male client admitted with a bowel obstruction and intractable vomiting is to insert a nasogastric tube to intermittent suction. This is based on the given lab results where the pH is 7.50, indicating alkalosis, the PaCO2 is 42 mmHg which is within the normal range, and the HCO3 is 33 mEq/L which is higher than normal. Considering these values, the primary issue appears to be metabolic alkalosis, likely due to the loss of stomach acid from persistent vomiting. A nasogastric tube would help alleviate the vomiting and remove gastric contents, which might alleviate some of the metabolic disturbances.