Question

A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect?

1) pH 7.32, PaCO₂36 mm Hg, HCO₃- 14 mEq/L
2) pH 7.38, PaCO₂55 mm Hg, HCO₃- 22 mEq/L
3) pH 7.44, PaCO₂40 mm Hg, HCO₃- 24 mEq/L
4) pH 7.50, PaCO₂42 mm Hg, HCO₃- 30 mEq/L

Answer 1

For a client with diabetic ketoacidosis (DKA), a nurse should expect to see decreased pH and bicarbonate levels with a PaCO₂ that may be normal or low due to respiratory compensation. Option 1 with a pH of 7.32, PaCO₂ of 36 mm Hg, and HCO₃⁻ of 14 mEq/L aligns with the expected laboratory values for DKA.

Step-by-step explanation:

A nurse reviewing laboratory values for a client with diabetic ketoacidosis (DKA) should expect certain specific changes in blood gas results. In DKA, the normal pH range of the blood, which is 7.35-7.45, decreases to a lower value due to the production of ketoacids. This results in metabolic acidosis. Lab tests will reflect this with a low pH, low HCO₃ (bicarbonate), and a PaCO₂ that may be normal or low due to respiratory compensation. Among the provided options, option 1 with a pH of 7.32, a PaCO₂ of 36 mm Hg, and HCO₃⁻ of 14 mEq/L is consistent with metabolic acidosis due to DKA.

The low pH indicates acidosis, PaCO₂ is slightly on the lower end but may represent respiratory compensation, and the HCO₃⁻ is significantly decreased, confirming a metabolic origin of the acidosis. Respiratory compensation is a mechanism where increased respiration rate and depth are seen in response to metabolic acidosis to decrease CO₂ levels and thus increase blood pH. None of the other options reflect the typical lab values for DKA, as they either have normal or high pH values, or bicarbonate levels that do not indicate severe acidosis.