The emergency department nurse cares for 5 clients. Which of the clients below are at risk for developing metabolic acidosis? Select all that apply.

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11ecbb05_ca78_d62f_b433_4fa4cb520bec_MD0009_00 Metabolic acidosis is due to an increase in the production or retention of acid or the depletion of bicarbonate via the kidneys or gastrointestinal (GI) tract. In metabolic acidosis there is a decrease in pH (<7.35) and HCO₃- (<22 mEq [22 mmol/L]). Common causes of metabolic acidosis include: GI bicarbonate losses (eg, diarrhea) (Option B) Ketoacidosis (eg, diabetes, alcoholism, starvation) Lactic acidosis (eg, sepsis, hypoperfusion) (Option D) Renal failure (eg, hemodialysis with inaccessible arteriovenous shunt) (Option E) Salicylate toxicity (Option A) A client with claustrophobia who was stuck in an elevator is at risk for an anxiety attack, which leads to hyperventilation and respiratory alkalosis (pH >7.45, PaCO2 <35 mm Hg [4.66 kPa]). (Option C) A client with excessive vomiting is at risk for metabolic alkalosis due to loss of stomach acid. Educational objective: Conditions that increase acid production or retention (eg, ketoacidosis, lactic acidosis, renal failure) or bicarbonate depletion (eg, diarrhea) can put a client at risk for metabolic acidosis (pH <7.35, HCO₃- <22 mEq/L [22 mmol/L]).

The Emergency Department Nurse Cares for 5 Clients