Metabolic acidosis is characterized by an increase in acid or a decrease in bicarbonate in the body, leading to a lower pH in the blood. In the context of the given options, a patient experiencing ongoing vomiting and diarrhea for an extended period can indeed lead to metabolic acidosis.
When a person vomits, the loss of stomach contents results in a loss of stomach acid, which can lead to an imbalance in the electrolytes and acid-base status. Diarrhea can also contribute to acid-base imbalances by leading to the loss of bicarbonate in the stool. Over a prolonged period, such as the 26 hours mentioned, the combination of these losses can cause metabolic acidosis due to the depletion of bicarbonate and the accumulation of metabolic acids.
The young athlete may experience a temporary lactic acidosis due to intense exercise, but this is generally a transient condition that resolves as they recover. A patient with chronic kidney disease might develop acid-base disturbances, often leaning towards metabolic acidosis as the disease progresses, but this can vary based on their specific condition and management. A healthy adolescent is unlikely to experience metabolic acidosis as they maintain normal metabolic function and homeostasis.
In the specific case of the older adult with prolonged vomiting and diarrhea,