A patient newly diagnosed with diabetes mellitus is admitted to the emergency department with nausea, vomiting, and abdominal pain. ABG results reveal a pH of 7.2 and a bicarbonate level of 20 mEq/L. What other assessment findings should the nurse anticipate in this patient? Select all that apply.

Sodium 155 mEq/L. Choice A rationale:

A urine specific gravity of 1.035 indicates concentrated urine and is consistent with fluid volume deficit. However, it is not the most specific finding for this condition.

Choice B rationale:

A BUN (blood urea nitrogen) level of 19 mg/dL can be a normal value. It is within the reference range (usually around 7-20 mg/dL) and does not provide specific information about fluid volume deficit.

Choice C rationale:

A hematocrit of 44.9% can also be within the normal range for some individuals, and while it can be elevated in cases of fluid volume deficit, it is not as sensitive as other parameters for detecting this condition.

Choice D rationale:
This is the correct answer because a sodium level of 155 mEq/L is elevated and indicates hypernatremia, which is associated with fluid volume deficit. Hypernatremia occurs when there is a relative lack of water in relation to the sodium concentration in the blood, and it can lead to dehydration

Choice A rationale:

Dysrhythmias are not a direct consequence of diabetic ketoacidosis (DKA) or the acid-base imbalance indicated by the patient's pH of 7.2 and bicarbonate level of 20 mEq/L. DKA primarily affects the respiratory system, leading to Kussmaul respirations, not dysrhythmias.

Choice B rationale:

Kussmaul respirations are an expected finding in a patient with diabetic ketoacidosis (DKA) and metabolic acidosis. These deep, rapid breaths are the body's attempt to compensate for the acidosis by eliminating excess CO2.

Choice C rationale:

Weakness is a common symptom of DKA. The hyperglycemia and acidosis result in intracellular dehydration and impaired cellular function, leading to weakness and fatigue.

Choice D rationale:

Cold, clammy skin is not typically associated with DKA. Instead, patients with DKA may have warm, dry skin due to dehydration and impaired thermoregulation.

Choice E rationale:

Tachycardia is an expected finding in a patient with DKA. The metabolic acidosis and dehydration lead to an increase in heart rate as the body attempts to maintain perfusion.