The nurse observed that a client with diabetic ketoacidosis is experiencing abnormally deep, regular, and rapid respirations. How would the nurse document this observation in the medical record?

Choice A reason: Kidney function is not indicated by the PaCO2 level, but rather by the creatinine and blood urea nitrogen (BUN) levels. The kidneys are responsible for regulating the HCO3- level, which is the other component of the carbonic acid-bicarbonate buffer system.

Choice B reason: Bicarbonate buffers are not indicated by the PaCO2 level, but rather by the HCO3- level. Bicarbonate buffers are substances that can accept or donate hydrogen ions to maintain the pH of the blood. They are part of the carbonic acid-bicarbonate buffer system, which is the main buffer system in the body.

Choice C reason: Phosphate buffers are not indicated by the PaCO2 level, but rather by the PO4^3^- level. Phosphate buffers are substances that can accept or donate hydrogen ions to maintain the pH of the intracellular fluid and the urine. They are part of the phosphoric acid-phosphate buffer system, which is the second most important buffer system in the body.

Choice D reason: Lung ventilation is indicated by the PaCO2 level, which is the partial pressure of carbon dioxide in the blood. Lung ventilation is the process of moving air in and out of the lungs, which affects the amount of carbon dioxide exhaled. The lungs are responsible for regulating the PaCO2 level, which is the other component of the carbonic acid-bicarbonate buffer system.

Choice A reason: 60 mL of urine in a 2-hour period is not very concerning for a nurse, as it is within the normal range of urine output. The average urine output for an adult is about 1 to 2 L per day, or 40 to 80 mL per hour¹.

Choice B reason: 720 mL of urine in a 24-hour period is slightly below the normal range, but not alarming. It may indicate mild dehydration or reduced fluid intake, but it is not a sign of fluid volume excess or kidney failure¹.

Choice C reason: 600 mL of urine in a 10-hour period is also within the normal range of urine output, and does not indicate any problem with fluid balance or renal function¹.

Choice D reason: 100 mL of urine in a 5-hour period is the most concerning for a nurse, as it indicates oliguria, or abnormally low urine output. Oliguria is defined as urine output less than 400 mL per day, or less than 20 mL per hour². It may be caused by acute or chronic kidney injury, urinary obstruction, shock, dehydration, or fluid volume excess². Oliguria can lead to fluid overload, electrolyte imbalance, acidosis, and uremia, and requires immediate medical attention².