What acid-base imbalance should a nurse be vigilant for in a client with ulcerative colitis who has experienced severe diarrhea?

In a client with ulcerative colitis who has experienced severe diarrhea, metabolic acidosis is the primary acid-base imbalance to be vigilant for, due to significant fluid and electrolyte loss. Diarrhea can lead to rapid elimination of bicarbonate, which is a base, thereby increasing the acidity of the blood and resulting in decreased pH.

The gastrointestinal tract plays a crucial role in maintaining acid-base balance, and when diarrhea occurs, especially in the context of inflammatory bowel diseases like ulcerative colitis, the body loses not only water and sodium but also bicarbonate. This loss manifests as an accumulation of hydrogen ions, leading to a state of acidosis.

Furthermore, in conditions like ulcerative colitis, inflammation and ulceration can impair the absorption capabilities of the intestines, exacerbating the losses and contributing to the risk of metabolic acidosis. Therefore, monitoring for signs of this imbalance is critical in managing a patient with ulcerative colitis who is experiencing severe diarrhea.