Your patient has been vomiting and you insert an NG tube to suction to decompress his stomach. Which lab study will you be watching for changes related to this intervention? 单项选择题
A
CBC
B
Electolytes
C
Lipid profile
D
Serum amylase

Question

Your patient has been vomiting and you insert an NG tube to suction to decompress his stomach.  Which lab study will you be watching for changes related to this intervention?

BlackTom AI · Accepted Answer

Nasogastric suction removes gastric hydrochloric acid and chloride, producing a hypochloremic metabolic alkalosis and notable electrolyte disturbances — so you will monitor electrolytes.

1) Relevant knowledge points and concepts
- Gastric fluid contains H+ and Cl− (HCl). Vomiting or NG suction causes loss of these ions and fluid.
- Loss of H+ raises serum bicarbonate, causing metabolic alkalosis. Loss of Cl− and volume contraction lead to hypochloremia and activation of aldosterone.
- Aldosterone-mediated renal compensation causes sodium retention and potassium (and hydrogen) loss, producing hypokalemia. Magnesium and calcium can also be affected.
- Lab monitoring therefore focuses on serum electrolytes (Na+, K+, Cl−, HCO3−) and often Mg2+ and Ca2+, and may include arterial blood gas for acid–base status.

2) Step-by-step reasoning
- Patient vomits and NG suction is applied → net removal of HCl and fluid from stomach.
- Immediate effect: decreased H+ and Cl− in body fluids → relative increase in serum bicarbonate → metabolic alkalosis.
- Volume depletion from fluid loss → RAAS activation → aldosterone causes renal Na+ reabsorption and K+ (and H+) excretion → hypokalemia and further maintenance of alkalosis.
- Therefore the most important labs to watch are electrolyte panels showing Na+, K+, Cl−, and HCO3− (and Mg2+, Ca2+ as needed).

3) Calculations
- No numeric calculations required; follow serial lab values to track trends in Na, K, Cl, HCO3.

4) Why the correct answer is correct
- “Electolytes” (electrolytes) directly reflect the ionic and acid–base derangements produced by vomiting and NG suction and guide replacement therapy.

5) Why other options are incorrect
- CBC: evaluates hemoglobin, hematocrit, WBCs — not primary for tracking fluid/electrolyte loss.
- Lipid profile: measures cholesterol/triglycerides — unrelated to NG suction.
- Serum amylase: elevated in pancreatitis/salivary issues — not useful for monitoring gastric suction effects.

Conclusion: Monitor electrolytes — Final answer: Electolytes.

Your patient has been vomiting and you insert an NG tube to suction to decompress his stomach. Which lab study will you be watching for changes related to this intervention? 单项选择题

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