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    Ati nurs 662 med surg proctored exam

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

    Explanation & Rationale

    A. pH 7.38, PaCO₂ 55 mmHg, HCO₃ 22 mEq/dL: A near-normal pH with elevated PaCO₂ suggests respiratory acidosis with partial compensation rather than a primary metabolic acidosis. DKA is characterized by low pH and low bicarbonate due to accumulation of ketone acids. These values do not reflect that pattern. B. pH 7.50, PaCO₂ 42 mmHg, HCO₃ 30 mEq/dL: An elevated pH and increased bicarbonate indicate metabolic alkalosis. DKA involves excess acid production, not alkalosis. These findings are inconsistent with ketone-driven acid–base changes. C. pH 7.32, PaCO₂ 38 mmHg, HCO₃ 14 mg/dL: A low pH with markedly decreased bicarbonate reflects metabolic acidosis. In DKA, bicarbonate is consumed buffering ketone acids, and PaCO₂ may be normal or slightly decreased due to compensatory hyperventilation. These values align with expected acid–base disturbances. D. pH 7.44, PaCO₂ 40 mmHg, HCO₃ 24 mg/dL: Normal pH, PaCO₂, and bicarbonate indicate a stable acid–base balance. DKA presents with significant metabolic derangements rather than normal laboratory findings.

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