A nurse is evaluating a client who was recently admitted with a diagnosis of diabetic ketoacidosis (DKA). The nurse draws an arterial blood gas (ABG) sample to assess the client's acid-base balance. Which of the following ABG findings are consistent with the primary acid-base disturbance and the expected physiological compensation for this condition? Select all that apply.
- Arterial pH of Cevap
- Bicarbonate () level of mEq/LCevap
- Partial pressure of carbon dioxide () of mm HgCevap
- DArterial pH of
- EPartial pressure of carbon dioxide () of mm Hg
Cevap
The expected findings include an arterial pH of 7.28, a bicarbonate level of 14 mEq/L, and a PaCO2 of 28 mm Hg.
The correct findings represent a state of partially compensated metabolic acidosis, which is expected in diabetic ketoacidosis. The accumulation of ketoacids decreases the arterial pH (acidemia) and consumes bicarbonate, resulting in a low bicarbonate level. The body adapts to this metabolic acidosis via respiratory compensation. The lungs attempt to blow off excess acid in the form of carbon dioxide through deep, rapid breathing (Kussmaul respirations). This compensatory hyperventilation lowers the partial pressure of carbon dioxide below the normal range of 35-45 mm Hg.
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Diabetic ketoacidosis leads to metabolic acidosis with compensatory respiratory alkalosis.
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