A nurse is assessing a client who has type 1 diabetes mellitus and has a blood glucose level of 550 mg/dL. Which of the following should the nurse assess the client for if diabetic ketoacidosis (DKA) is suspected?

Choice A reason: Specific gravity is typically increased in clients who have hypovolemia, not decreased, due to the concentration of urine as the body atempts to conserve water.

Choice B reason: Creatinine levels are indeed increased in clients who have acute kidney injury, reffecting decreased kidney function and filtration.

Choice C reason: Potassium levels are not necessarily increased in clients who have polyuria. Polyuria can be associated with a variety of conditions and does not directly indicate high potassium levels.

Choice D reason: BUN, or blood urea nitrogen, is typically increased in clients who have dehydration, not decreased, due to the concentration of blood solutes as the body conserves water.

The correct answer is D. Urine output 75 mL in 1 hr.

Adequate urine output (at least 30 mL/hr) indicates effective hydration, showing that the kidneys are functioning properly and fluid balance is improving. A urine output of 75 mL in 1 hour suggests sufficient fluid replacement.

Here’s why the other options are incorrect:

• A. Urine specific gravity 1.005 to 1.030 – This range covers both normal and abnormal values. In dehydration, urine specific gravity is usually high (>1.030) due to concentrated urine. Effective treatment should lead to lower urine specific gravity, but the full range does not confirm improvement.

• B. Decreased pulse pressure – Pulse pressure is the difference between systolic and diastolic blood pressure. Dehydration typically causes a narrowed pulse pressure, so improvement should lead to a normal or increased pulse pressure rather than a decrease.

• C. Lightheadedness – Dizziness and lightheadedness are signs of dehydration-related hypotension. Effective hydration should resolve these symptoms, not maintain them.