Question

A client reports vomiting every hour for the past 8 to 10 hours. The nurse should assess the client for risk of which of the following? Select all that apply.

A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Hypokalemia.
D. Hyperkalemia.
E. Hyponatremia.

Answer 1

A client with persistent vomiting should be assessed for metabolic alkalosis, hypokalemia, and hyponatremia. Prolonged vomiting leads to a loss of HCI and electrolytes, which causes these conditions, whereas metabolic acidosis and hyperkalemia are less likely associated with vomiting.

Step-by-step explanation:

Regarding the given scenario where a client has been vomiting every hour for the past 8 to 10 hours, certain electrolyte imbalances and acid-base disturbances should be assessed for. The nurse should be alert for risks of the following conditions caused by severe and prolonged vomiting:

• Metabolic alkalosis: Prolonged vomiting can lead to the loss of hydrogen and chloride ions as components of hydrochloric acid (HCI), which can result in the body developing metabolic alkalosis.
• Hypokalemia: Vomiting can also cause a significant loss of potassium ions, especially if diuretics - which further exacerbate potassium loss - are involved.
• Hyponatremia: Persistent vomiting can lead to the loss of sodium along with fluid, leading to a decrease in blood sodium levels, known as hyponatremia.

It is important to note that while metabolic acidosis can occur due to conditions like renal disease or diabetic ketoacidosis, it is less likely associated with the scenario of repeated vomiting, which typically leads to metabolic alkalosis instead of acidosis. Similarly, hyperkalemia is typically not associated with vomiting and the subsequent loss of potassium.

Therefore, the correct answers would be B. Metabolic alkalosis, C. Hypokalemia, and E. Hyponatremia.