MEDizzy - A client manages peptic ulcer disease (PUD) with excessive

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Integrated Process II

A client manages peptic ulcer disease (PUD) with excessive amounts of oral antacids. Signs/symptoms of which acid–base imbalance should the nurse assess for?

ExplanationOral antacids can be effective treatment for PUD when administered properly, but when they are taken in excess they can lead to metabolic alkalosis (a pH of more than 7.45 and a bicarbonate ion [HCO3] level of more than 27 mEq/L [27 mmol/L]). As effective therapy for PUD, antacids bind with the hydrochloric acid (HCl–) of gastric secretions and halt the corrosive action of the HCl–. However, antacids are alkaline substances, and excessive administration can exceed the kidney’s ability to clear the excess HCO3, which leads to the accumulation of HCO3, an increased pH, and metabolic alkalosis. Metabolic acidosis occurs when the pH is low and the HCO3 is low; respiratory acidosis occurs when the pH is low and the partial pressure of carbon dioxide (Pco2) is high; and respiratory alkalosis occurs when the pH is high and the Pco2 is low.