A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

A. Purple striations: Purple striations are characteristic of Cushing's syndrome due to prolonged exposure to high levels of cortisol. They are not associated with Addison's disease, which involves adrenal insufficiency and low cortisol levels.

B. Hirsutism: Hirsutism, or excessive hair growth, is not a feature of Addison's disease. It is more commonly associated with conditions involving high androgen levels, such as polycystic ovary syndrome or Cushing's syndrome.

C. Intention tremors: Intention tremors are associated with neurological conditions like multiple sclerosis or essential tremor, not Addison's disease. Addison's primarily affects hormone levels and fluid balance.

D. Hyperpigmentation: Hyperpigmentation, particularly in areas like the skin creases, gums, and around scars, is a hallmark sign of Addison's disease. It is due to increased production of melanocyte-stimulating hormone (MSH) as a result of elevated levels of adrenocorticotropic hormone (ACTH).

A. Blood glucose level below 40 mg/dL: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, typically with blood glucose levels significantly elevated above normal, often exceeding 250 mg/dL. A glucose level below 40 mg/dL would indicate hypoglycemia, which is not a feature of DKA.

B. Malignant hypertension: Malignant hypertension is a condition characterized by extremely high blood pressure and is not directly associated with DKA. DKA primarily involves issues with glucose and acid-base balance rather than hypertension.

C. Cheyne-Stokes breathing: Cheyne-Stokes breathing is a specific pattern of periodic breathing typically seen in severe neurologic conditions or heart failure, not in DKA. DKA is associated with Kussmaul breathing, which is deep and rapid breathing as the body attempts to compensate for metabolic acidosis.

D. Acetone odor to breath: An acetone (fruity) odor to the breath is a classic sign of DKA due to the presence of ketones in the blood and urine. This occurs because the body is breaking down fatty acids for energy, leading to the production of ketones, which are then excreted through the breath and urine.