A nurse is reviewing laboratory results for a client who has diabetic ketoacidosis (DKA).

Which finding should alert the nurse to a potential complication of DKA?

Place the client in a negative pressure isolation room.

Rationale: Placing the client in a negative pressure isolation room is an intervention that prevents the transmission of TB to other clients and staff. Negative pressure rooms have ventilation systems that create a lower pressure inside the room than outside, causing air to flow into the room and preventing air from escaping.

Incorrect options:

B) Administer a single antitubercular medication daily. - This is an incorrect intervention, as TB requires combination therapy with multiple antitubercular medications to prevent drug resistance and ensure effective treatment. The standard regimen for TB consists of four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide.

C) Obtain three consecutive sputum cultures for acid-fast bacilli (AFB). - This is an intervention that is done before the diagnosis of TB is confirmed, not after. Sputum cultures for AFB are used to identify the presence of Mycobacterium tuberculosis, the causative agent of TB. Three consecutive negative sputum cultures are required to declare the client noninfectious.

D) Instruct the client to wear a surgical mask when outside the room. - This is an incorrect intervention, as surgical masks do not provide adequate protection against TB. The client should wear a high-efficiency particulate air (HEPA) respirator when outside the room, which filters out 99.97% of airborne particles.

Serum potassium level of 6.5 mEq/L

Rationale: A serum potassium level of 6.5 mEq/L indicates hyperkalemia, which is a potential complication of DKA due to insulin deficiency, acidosis, and dehydration. Hyperkalemia can cause cardiac dysrhythmias, muscle weakness, and paresthesia.

Incorrect options:

A) Blood glucose level of 350 mg/dL - This is an expected finding for a client who has DKA, as insulin deficiency leads to hyperglycemia and glycosuria. The goal of treatment for DKA is to lower blood glucose levels gradually to prevent cerebral edema.

C) Arterial blood pH of 7.25 - This is an expected finding for a client who has DKA, as insulin deficiency leads to increased breakdown of fatty acids and production of ketones, resulting in metabolic acidosis. The normal range for arterial blood pH is 7.35 to 7.45.

D) Serum bicarbonate level of 18 mEq/L - This is an expected finding for a client who has DKA, as metabolic acidosis causes a decrease in serum bicarbonate levels due to buffering mechanisms. The normal range for serum bicarbonate levels is 22 to 26 mEq/L.