A preschool-age child has been experiencing severe vomiting for over 24 hours. The child's respiratory rate is currently 10 breaths/min. On which health problem will the nurse focus when caring for this child?
A) Overhydration
B) Metabolic acidosis
C) Metabolic alkalosis
D) Hypertonic dehydration
C
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With vomiting, a great deal of hydrochloric acid is lost. When Cl– ions are lost this way, the body has to decrease the number of H+ ions present so the number of positive and negative charges remains balanced. This causes the child to develop alkalosis. The lungs attempt to conserve carbon dioxide and water by slowing respirations. Overhydration generally occurs in children who are receiving IV fluid, ingestion of large quantities of tap water, or through the use of tap water enemas. Metabolic acidosis is more closely associated with diarrhea. Hypertonic dehydration occurs when water is lost in a greater proportion than electrolytes. This might occur in a child with nausea, fever, and profuse diarrhea.
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