A child who has been vomiting for 3 days is admitted for correction of fluid and electrolyte imbalances. Which acid-base imbalance is this child likely to exhibit?

Rationale: A. Respiratory acidosis: Respiratory acidosis occurs when hypoventilation leads to CO₂ retention and carbonic acid buildup in the blood. It is associated with conditions like pneumonia, asthma, or neuromuscular weakness rather than gastrointestinal losses. B. Metabolic alkalosis: Metabolic alkalosis occurs when prolonged vomiting leads to the loss of gastric hydrochloric acid, reducing hydrogen ion concentration in the blood. This loss of acid causes a relative excess of bicarbonate, making it the most likely imbalance for a child vomiting for 3 days. C. Metabolic acidosis: Metabolic acidosis occurs when there is either excessive acid production or loss of bicarbonate, as in diarrhea or diabetic ketoacidosis. Because vomiting removes stomach acid instead of bicarbonate, this imbalance would not be expected here. D. Respiratory alkalosis: Respiratory alkalosis occurs when hyperventilation causes excessive exhalation of CO₂, leading to elevated blood pH. Since vomiting does not impact ventilation directly, respiratory alkalosis is not the likely disturbance in this scenario.