Question

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

a) pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L
b) pH 7.38, PaCO2 55 mm Hg, HCO3- 22 mEq/L
c) pH 7.44, PaCO2 40 mm Hg, HCO3- 24 mEq/L
d) pH 7.50, PaCO2 42 mm Hg, HCO3- 30 mEq/L

Answer 1

A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). The nurse should expect pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L. Therefore, the correct option is a) pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L.

Step-by-step explanation:

Diabetic ketoacidosis (DKA) is characterized by an acid-base imbalance marked by low pH (acidosis), decreased bicarbonate (HCO3-), and increased levels of blood ketones. In DKA, due to the lack of insulin or insufficient action of insulin, the body resorts to using fat for energy, resulting in ketone production, causing metabolic acidosis. The key lab values indicating this state are a low pH (indicating acidosis), low bicarbonate (HCO3-), and normal to low-normal PaCO2.

Option a) pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L, demonstrates acidosis (pH lower than the normal range of 7.35-7.45), low bicarbonate (HCO3- 14 mEq/L, below the normal range of 22-26 mEq/L), and the compensatory respiratory response (PaCO2 36 mm Hg) trying to normalize the pH.

The other options b), c), and d) show values within or close to the normal ranges for pH, PaCO2, and HCO3-. These values don't align with the expected lab findings seen in DKA, where there's a characteristic metabolic acidosis reflected by a low pH, low bicarbonate, and either normal or low-normal PaCO2 due to respiratory compensation.

Hence, option a) best represents the expected laboratory values for a client experiencing diabetic ketoacidosis, indicating metabolic acidosis with compensatory respiratory changes. Therefore, the correct option is a) pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L.

Answer 2

In diabetic ketoacidosis (DKA), expected laboratory values include a lower pH level than the normal range (7.35-7.45) and decreased bicarbonate levels, indicating metabolic acidosis. The correct laboratory values for DKA are pH 7.32, PaCO2 36 mm Hg, and HCO3- 14 mEq/L (option a).

Step-by-step explanation:

You asked about the expected laboratory values for a client with diabetic ketoacidosis (DKA). DKA leads to lowered blood pH levels due to increased ketone bodies, which are acidic. According to Table 26.3 of reference values, the normal arterial blood pH range is 7.35-7.45. In DKA, the blood pH decreases, which means the condition is metabolic acidosis.

Given this information, the expected laboratory results for a client experiencing DKA would include a decreased pH below the normal limit of 7.35 and low HCO3- values, as HCO3- is consumed to buffer the excess of acids in the blood. The PaCO2 may be normal or slightly decreased due to compensatory hyperventilation to blow off CO2 in response to the metabolic acidosis.

The correct answer from the given options, therefore, is a) pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L, which reflects a state of acidosis with compensation attempts that are typical of DKA.