A nurse is caring for a client who has a disposable three-chamber chest tube in place. Which of the following findings should indicate to the nurse that the client is experiencing a complication?

Choice A Reason: This choice is incorrect because oral hypoglycemic medications are not effective for treating DKA. Oral hypoglycemic medications are drugs that lower the blood glucose level by stimulating insulin secretion or increasing insulin sensitivity. They may be used for clients who have type 2 diabetes mellitus, but they do not work for clients who have type 1 diabetes mellitus or DKA.

Choice B Reason: This choice is correct because 0.9% sodium chloride IV bolus is an effective treatment for DKA. 0.9% sodium chloride is an isotonic solution that contains the same concentration of solutes as blood plasma. It may be used for clients who have fluid loss, dehydration, or shock. In DKA, the body breaks down fat for energy due to insulin deficiency or resistance, resulting in high levels of ketones and acids in the blood. This causes osmotic diuresis, dehydration, electrolyte imbalance, and metabolic acidosis. Therefore, administering 0.9% sodium chloride IV bolus can help to restore fluid volume and correct electrolyte imbalance.

Choice C Reason: This choice is incorrect because dextrose 5% in 0.45% sodium chloride is not indicated for treating DKA. Dextrose 5% in 0.45% sodium chloride is a hypertonic solution that contains more solutes than blood plasma. It may be used for clients who have hyponatremia, cerebral edema, or malnutrition, but it can worsen hyperglycemia and osmotic diuresis in clients who have DKA.

Choice D Reason: This choice is incorrect because glucocorticoid medications are not indicated for treating DKA. Glucocorticoid medications are drugs that mimic the effects of cortisol, a hormone that regulates stress response and inflammation. They may be used for clients who have allergic reactions, asthma, or autoimmune diseases, but they can increase blood glucose levels and inhibit insulin action in clients who have DKA.

Choice A Reason: This is correct because respiratory acidosis is characterized by a low pH and a high PaCO2, indicating that the client has impaired ventilation and excess carbon dioxide in the blood.

Choice B Reason: This is incorrect because respiratory alkalosis is characterized by a high pH and a low PaCO2, indicating that the client has increased ventilation and reduced carbon dioxide in the blood.

Choice C Reason: This is incorrect because metabolic acidosis is characterized by a low pH and a low HCO3, indicating that the client has an excess of metabolic acids or a loss of base in the blood.

Choice D Reason: This is incorrect because metabolic alkalosis is characterized by a high pH and a high HCO3, indicating that the client has an excess of base or a loss of metabolic acids in the blood.