A 16-year-old presents at the emergency room with altered mental status, bradycardia, and cardiac dysrhythmia caused by uncontrolled diabetes mellitus. What acid–base imbalance is most likely occurring in this client?
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
A
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Metabolic acidosis can be caused by uncontrolled diabetes mellitus, fasting and starvation, lactic acidosis, salicylate poisoning, alcoholic ketoacidosis, kidney dysfunction and failure, and loss of intestinal secretions. Respiratory acidosis is caused by respiratory center depression, lung disorders, extreme obesity, respiratory muscle paralysis, and kyphoscoliosis. Causes of metabolic alkalosis are excess ingestion or administration of sodium bicarbonate, TPN solutions containing acetate, parenteral solutions containing lactate, or blood transfusions containing citrate; GI loss of hydrogen ions via vomiting, gastric suction, bulimia, diuretic therapy, and loss of chloride and body fluids. Respiratory alkalosis is caused by hysteria, hyperventilation, high fever, salicylate (aspirin) poisoning, elevated blood ammonia levels, encephalitis, and mechanical ventilation.
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