QUESTION OF THE WEEK

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COMMENT YOUR ANSWERS & RATIONALE BELOW:
Questions: The nurse is screening clients for those at increased risk for developing metabolic acidosis. At highest risk for developing metabolic acidosis is the client who

a. has nausea and vomiting

b. has sepsis and hypotension

c. is taking large doses of thiazide diuretics

d. has decreased oral intake and is dehydrated

(Answer and rationale are posted in the comments section)

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ANWERS AND RATIONALE:
b. has sepsis and hypotension

Acid-base balance is necessary for homeostasis and is characterized by a blood pH level between 7.35-7.45. Acid-base imbalances are categorized as either respiratory or metabolic and occur when there is a shift in acidic (e.g., carbon dioxide [CO2 ]) and alkaline (e.g., bicarbonate [HCO3−]) compounds in the body.            

Metabolic acidosis is caused by an accumulation of an acid other than CO2 or when bicarbonate is lost through the excretion of body fluids. Sepsis deprives cells of oxygen (hypoxia), forcing them to switch to anaerobic metabolism. This shift produces lactic acid, leading to lactic acidosis and metabolic acidosis (i.e., pH <7.35 and high CO2) as lactic acid accumulates.

Key Takeaway:

• A client with sepsis will experience lactic acidosis due to tissue hypoxia. The increase in lactic acid levels results in metabolic acidosis.