Progressive Care Nursing Certification (PCCN) Practice Exam

A patient is admitted with disorientation 3 weeks after gastrostomy-tube placement. What abnormality might result from the family's actions of irrigating the G-tube and aspirating after each feeding?

1. Metabolic acidosis

2. Metabolic alkalosis

3. Respiratory acidosis

4. Respiratory alkalosis

The correct answer is: Metabolic alkalosis

In the context of a patient who is disoriented three weeks after gastrostomy-tube placement, the action of the family irrigating the G-tube and aspirating after each feeding can lead to metabolic alkalosis. When the G-tube is irrigated and then aspirated, there is a risk of removing stomach contents that contain acid. This can result in a loss of gastric acid, which is primarily hydrochloric acid. As gastric acid is lost, the body's overall acid-base balance shifts towards alkalinity, causing an increase in blood pH, which is characteristic of metabolic alkalosis. Additionally, if this practice is frequent and not properly managed, it could lead to significant electrolyte imbalances, particularly with potassium and chloride, both of which are essential for maintaining acid-base balance and cellular function. In summary, the irrigation and aspiration practices may inadvertently contribute to a loss of acidic gastric content, leading to an elevated pH and the manifestation of metabolic alkalosis in the patient. This condition could explain the patient's disorientation, as significant acid-base imbalances can affect neurological function.