A nurse is reviewing their client’s lab results. Their client is being treated for hyperosmolar hyperglycemic state (HHS). Which of the following arterial blood gas values will the client exhibit?

Choice A reason: PaCO2 31 mmHg (normal 35-45 mmHg) suggests respiratory alkalosis, not typical in HHS. HHS primarily causes metabolic acidosis or normal pH due to severe hyperglycemia and dehydration, not respiratory compensation, making this an incorrect finding for HHS’s acid-base profile. Choice B reason: HCO3 15 mEq/L (normal 21-28 mEq/L) indicates metabolic acidosis, more common in DKA than HHS. HHS typically has normal or slightly reduced HCO3 due to minimal ketone production, making this finding less consistent with HHS’s metabolic profile. Choice C reason: pH 7.39 (normal 7.35-7.45) is expected in HHS, as it typically presents with minimal acidosis due to low ketone production compared to DKA. Severe hyperglycemia and hyperosmolarity dominate, with pH often remaining near normal, making this the correct finding. Choice D reason: pH 7.27 indicates significant acidosis, typical of DKA, not HHS. HHS involves severe hyperglycemia and dehydration with minimal ketosis, resulting in normal or slightly acidotic pH, making this finding inconsistent with the expected acid-base balance in HHS.