A nurse is reviewing the laboratory report of a client who has diabetic ketoacidosis (DKA) Which of the following findings should the nurse expect?

Serum glucose 600 mg/dL.

Serum bicarbonate 28 mEq/L.

Serum potassium 2.5 mEq/L.

Serum sodium 150 mEq/L.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Serum glucose 600 mg/dL. This is an expected finding for a client who has diabetic ketoacidosis (DKA) DKA results from a deficiency of insulin, which leads to hyperglycemia and ketosis. The normal range for serum glucose is 70 to 110 mg/dL.

Choice B reason:

Serum bicarbonate 28 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences ketosis, which results in ketones in the urine and blood. The nurse should expect a client who has DKA to have an HCO3- less than 15 mEq/L. This decreased value is due to an increased production of ketones, which results in metabolic acidosis. The normal range for serum bicarbonate is 22 to 26 mEq/L.

Choice C reason:

Serum potassium 2.5 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences osmotic diuresis and subsequent dehydration, which can cause electrolyte imbalances. The nurse should expect a client who has DKA to have elevated serum potassium levels due to the movement of potassium from the intracellular to the extracellular space in response to acidosis. The normal range for serum potassium is 3.5 to 5 mEq/L.

Choice D reason:

Serum sodium 150 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences osmotic diuresis and subsequent dehydration, which can cause electrolyte imbalances. The nurse should expect a client who has DKA to have decreased serum sodium levels due to the dilutional effect of excess glucose in the blood. The normal range for serum sodium is 136 to 145 mEq/L.

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Correct Answer is B

Explanation

Choice A reason:

Dextrose 5% in water (D5W) is a hypotonic solution that provides free water and calories, but no electrolytes. It is used to treat hypernatremia and cellular dehydration, but it can cause fluid shifts from the intravascular to the intracellular space, leading to cerebral edema and decreased blood pressure. This is not appropriate for a client who has dehydration due to vomiting and diarrhea, as they need to restore their intravascular volume and electrolyte balance.

Choice B reason:

Lactated Ringer's (LR) is an isotonic solution that contains sodium, chloride, potassium, calcium, and lactate. It is used to treat fluid loss from burns, trauma, surgery, or sepsis. It also helps to correct metabolic acidosis by providing bicarbonate precursors. This is the best choice for a client who has dehydration due to vomiting and diarrhea, as they need to replace their fluid and electrolyte losses and maintain their acid-base balance.

Choice C reason:

Dextrose 5% in 0.45% sodium chloride (D5W/0.45% NaCl) is a hypertonic solution that provides free water, calories, and sodium. It is used to treat hypovolemia and hyponatremia, but it can cause fluid shifts from the intracellular to the intravascular space, leading to cellular dehydration and increased blood pressure. This is not appropriate for a client who has dehydration due to vomiting and diarrhea, as they already have low blood pressure and cellular dehydration.

Choice D reason:

Dextrose 5% in lactated Ringer's (D5LR) is a hypertonic solution that provides free water, calories, sodium, chloride, potassium, calcium, and lactate. It is used to treat hypovolemia and metabolic acidosis, but it can cause fluid shifts from the intracellular to the intravascular space, leading to cellular dehydration and increased blood pressure. This is not appropriate for a client who has dehydration due to vomiting and diarrhea, as they already have low blood pressure and cellular dehydration.

A. pH 7.50, PaCO2 40 mm Hg, HCO3- 30 mEq/L. B. pH 7.35, PaCO2 35 mm Hg, HCO3- 24 mEq/L. C. pH 7.25, PaCO2 50 mm Hg, HCO3- 26 mEq/L. D. pH 7.30, PaCO2 30 mm Hg, HCO3- 18 mEq/L.

Correct Answer is A

Explanation

Choice A reason:

pH 7.50, PaCO2 40 mm Hg, HCO3- 30 mEq/L. This choice is correct because it shows a high pH, a normal PaCO2, and a high HCO3-, which are consistent with metabolic alkalosis. Metabolic alkalosis occurs when there is a loss of acid or a gain of base in the body fluids, such as from prolonged nasogastric suctioning. The kidneys try to compensate by excreting more bicarbonate, but this process is slow and incomplete.

Choice B reason:

pH 7.35, PaCO2 35 mm Hg, HCO3- 24 mEq/L. This choice is incorrect because it shows normal values for pH, PaCO2, and HCO3-, which indicate no acid-base imbalance. A client with metabolic alkalosis would have an elevated pH and bicarbonate level.

Choice C reason:

pH 7.25, PaCO2 50 mm Hg, HCO3- 26 mEq/L. This choice is incorrect because it shows a low pH, a high PaCO2, and a normal HCO3-, which are consistent with respiratory acidosis. Respiratory acidosis occurs when there is impaired gas exchange or hypoventilation, leading to an accumulation of carbon dioxide in the blood. The kidneys try to compensate by retaining more bicarbonate, but this process is slow and incomplete.

Choice D reason:

pH 7.30, PaCO2 30 mm Hg, HCO3- 18 mEq/L. This choice is incorrect because it shows a low pH, a low PaCO2, and a low HCO3-, which are consistent with metabolic acidosis. Metabolic acidosis occurs when there is a gain of acid or a loss of base in the body fluids, such as from diabetic ketoacidosis or diarrhea. The lungs try to compensate by increasing the rate and depth of breathing to expel more carbon dioxide, but this process is fast and limited.

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A nurse is reviewing the laboratory report of a client who has diabetic ketoacidosis (DKA) Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has dehydration due to vomiting and diarrhea. The client's blood pressure is 90/60 mm Hg, pulse is 110/min, and respirations are 22/min. The nurse should anticipate a prescription for which of the following types of IV fluids?

Correct Answer is B

Explanation

A nurse is caring for a client who has metabolic alkalosis as a result of prolonged nasogastric suctioning. The nurse should expect which of the following arterial blood gas values?

Correct Answer is A

Explanation

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