A client with congestive heart failure is voiding large amounts of urine via indwelling urinary catheter. Which acid-base balance does the nurse recognize the client is at greatest risk for developing?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
B) Metabolic alkalosis
Explanation: A) Diuretic-induced loss of the cation Na+ in the urine is accompanied by an approximately equal loss of the anion Cl- in the urine. Hypovolemia caused by these diuretics stimulates aldosterone secretion. Stimulation of aldosterone causes increased renal bicarbonate resorption and an increase in H+ secretion into the urine. This leads to metabolic alkalosis (due to increased bicarbonate resorption and loss of acid). Metabolic acidosis, respiratory acidosis, and respiratory alkalosis do not occur as a result of diuretic administration.
B) Diuretic-induced loss of the cation Na+ in the urine is accompanied by an approximately equal loss of the anion Cl- in the urine. Hypovolemia caused by these diuretics stimulates aldosterone secretion. Stimulation of aldosterone causes increased renal bicarbonate resorption and an increase in H+ secretion into the urine. This leads to metabolic alkalosis (due to increased bicarbonate resorption and loss of acid).
C) Diuretic-induced loss of the cation Na+ in the urine is accompanied by an approximately equal loss of the anion Cl- in the urine. Hypovolemia caused by these diuretics stimulates aldosterone secretion. Stimulation of aldosterone causes increased renal bicarbonate resorption and an increase in H+ secretion into the urine. This leads to metabolic alkalosis (due to increased bicarbonate resorption and loss of acid). Metabolic acidosis, respiratory acidosis, and respiratory alkalosis do not occur as a result of diuretic administration.
D) Diuretic-induced loss of the cation Na+ in the urine is accompanied by an approximately equal loss of the anion Cl- in the urine. Hypovolemia caused by these diuretics stimulates aldosterone secretion. Stimulation of aldosterone causes increased renal bicarbonate resorption and an increase in H+ secretion into the urine. This leads to metabolic alkalosis (due to increased bicarbonate resorption and loss of acid). Metabolic acidosis, respiratory acidosis, and respiratory alkalosis do not occur as a result of diuretic administration.
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