When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following?
A. Tachypnea
B. Shallow respirations
C. A reduced white blood cell count
D. A decreased platelet count
Correct Answer: A. Tachypnea
The body compensates for metabolic acidosis via the respiratory system, which tries to eliminate the buffered acids by increasing alveolar ventilation through deep, rapid respirations. As the body attempts to compensate for worsening acidosis, the respiratory rate increases to reduce the pCO2 and maintain a compensated physiological pH.
Option B: Initially, the breathing is rapid, but as it worsens, it gradually becomes deep and labored. Extra ketones in the body cause acid to build up in the blood. Because of this, the respiratory system is triggered to start breathing faster. Faster breathing helps expel more carbon dioxide, which is an acidic compound in the blood.
Option C: An elevation of the white blood cell (WBC) count is a nonspecific finding, but it should prompt consideration of septicemia, which causes lactic acidosis. Severe anemia with compromised oxygen delivery may cause lactic acidosis.
Option D: Altered platelet counts are not specific signs of metabolic imbalance. Acidosis compromises the clotting process and accelerates fibrinogen consumption with no effect on fibrinogen production, resulting in a deficit in fibrinogen availability.