Patient with pyloric stenosis secondary to peptic ulcer, complains of profuse vomitting and Na+ – 125 meq/L, K+ → 2.3 meq/L and CI → 85 meq/L, E- 8meq/L should be given-
**Core Concept**
Pyloric stenosis leads to gastric outlet obstruction, causing severe vomiting and electrolyte imbalances. In this scenario, the patient has a life-threatening degree of hypokalemia, hypochloremia, and hypochloremic alkalosis due to prolonged vomiting.
**Why the Correct Answer is Right**
The patient requires aggressive replacement of potassium, chloride, and bicarbonate to correct the associated metabolic acidosis and alkalosis. Intravenous fluids containing potassium chloride and bicarbonate are essential to rapidly correct the electrolyte imbalance and prevent cardiac complications. The use of potassium chloride is crucial as it provides both potassium and chloride ions, which are essential for correcting the hypokalemia and hypochloremia.
**Why Each Wrong Option is Incorrect**
**Option A:** This option may be tempting, but it only addresses the potassium deficiency without considering the chloride and bicarbonate imbalances.
**Option B:** This option may be partially correct, but it does not account for the chloride and bicarbonate deficits associated with pyloric stenosis.
**Option C:** This option may be a distractor, but it does not specifically address the electrolyte imbalances and metabolic acidosis associated with pyloric stenosis.
**Clinical Pearl / High-Yield Fact**
In patients with pyloric stenosis, it is essential to remember that the vomitus often contains hydrochloric acid, leading to a significant loss of chloride and hydrogen ions. This can result in a severe metabolic alkalosis, which must be corrected with intravenous fluids containing potassium chloride and bicarbonate.
**Correct Answer:** B. Potassium chloride and bicarbonate.