Which client is at the greatest risk for developing an acid–base imbalance or electrolyte disorder?
1. A client who has a gastrostomy tube
2. 18-month-old who has had watery stools for 3 days
3. 70-year-old with constipation
4. 27-year-old with a 24-hour history of nausea and vomiting
Correct Answer: 2
Rationale 1: A client who has a gastrostomy tube, if well maintained, should not be at risk for fluid loss.
Rationale 2: Diarrhea is a symptom, not a disease, of an underlying problem. It can be caused by medications, infections, chemicals, or inflammatory disorders. When prolonged or severe, especially in children, diarrhea can result in significant loss of body fluids that leads to acid–base or electrolyte disorders.
Rationale 3: Constipation would not cause acid–base imbalances.
Rationale 4: A 24-hour history of nausea and vomiting, especially in a young adult, would not be a significant risk for the client.
Global Rationale: Diarrhea is a symptom, not a disease, of an underlying problem. It can be caused by medications, infections, chemicals, or inflammatory disorders. When prolonged or severe, especially in children, diarrhea can result in significant loss of body fluids that leads to acid—base or electrolyte disorders. A client who has a gastrostomy tube, if well maintained, should not be at risk for fluid loss. Constipation would not cause acid—base imbalances. A 24-hour history of nausea and vomiting, especially in a young adult, would not be a significant risk for the client.
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