Patho Patho #39

Question

Expected findings in a client with diabetic ketoacidosis include:

Answers

  1. K+ 3.0 mEq.
    • Rationale:

      This answer choice is not correct because a K+ level of 3.0 mEq/L is very low. Hypokalemia is the most important cause of mortality in DKA clients and is therefore not an expected finding.

  2. reports of abdominal pain.
    • Rationale:

      This answer is correct because clients with DKA will often report abdominal pain due to the state of metabolic acidosis and the breakdown of fat to be used for fuel.

  3. blood pressure 78/48.
    • Rationale:

      This answer choice is not correct because a blood pressure of 78/48 is very low. Hypotension in the setting of DKA is an indicator of severe hypovolemia and is not an expected finding.

  4. respiratory acidosis.
    • Rationale:

      This answer choice is not correct because clients with DKA develop metabolic acidosis as opposed to respiratory acidosis due to lipolysis and the use of fat for fuel.

Overview

This question is asking the nurse to identify which manifestation the nurse should expect when assessing a client with diabetic ketoacidosis (DKA). DKA occurs in clients with pre-existing diabetes mellitus Type I when exposed to physical or psychosocial stress. The stress response releases hormones which cause hyperglycemia and acidosis. Metabolic acidosis associated with DKA causes the client to experience abdominal pain.

Explanation

Learning Outcomes

DKA is extreme hyperglycemia with associated metabolic acidosis that occurs in clients with Type I diabetes mellitus. Acidosis occurs due to the breakdown of fat instead of glucose due to the absolute deficiency of insulin. As a result of lipolysis, a metabolic acidosis develops with decreased pH and HCO3 levels. Reports of abdominal pain are expected in these clients because of the presence of metabolic acidosis and the breakdown of fat to be used for fuel.

Test Taking Tip

Make sure to always be able to recognize manifestations that are EXPECTED vs. signs/symptoms of potential vertical complications. Critical complications are not expected and the nurse should monitor for and intervene when present.

Video Rationale