A nurse is caring for a client who has diabetic ketoacidosis (DK
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
The Correct Answer is B
Choice A reason: Metabolic alkalosis is a condition characterized by an elevated pH in body tissues, typically due to an excess of bicarbonate or a loss of hydrogen ions. This condition is not associated with Kussmaul breathing. Kussmaul breathing is a deep and labored breathing pattern often seen in patients with metabolic acidosis, not alkalosis. In metabolic alkalosis, the body does not need to expel excess acid through rapid breathing, so Kussmaul respirations are not observed.
Choice B reason: Metabolic acidosis is a condition where there is an excess of acid in the body due to the accumulation of acid or the loss of bicarbonate. This condition is commonly seen in diabetic ketoacidosis (DKA), where the body produces high levels of ketones, leading to acidosis. Kussmaul breathing is a compensatory mechanism in metabolic acidosis, where the body attempts to reduce the acid level by expelling carbon dioxide through rapid, deep breaths. This type of breathing helps to lower the blood’s acidity by reducing the concentration of carbon dioxide, which is an acid.
Choice C reason: Respiratory alkalosis is a condition where there is a decrease in carbon dioxide levels in the blood due to excessive breathing or hyperventilation. This condition leads to an increase in blood pH, making it more alkaline. Kussmaul breathing is not associated with respiratory alkalosis because it is a response to metabolic acidosis, not a condition where the body is already expelling too much carbon dioxide.
Choice D reason: Respiratory acidosis is a condition where there is an excess of carbon dioxide in the blood due to inadequate respiration. This leads to a decrease in blood pH, making it more acidic. While respiratory acidosis involves an acidic environment, Kussmaul breathing is specifically a response to metabolic acidosis, not respiratory acidosis. In respiratory acidosis, the body would not use Kussmaul respirations as a compensatory mechanism.
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Correct Answer is D
Explanation
Choice A reason: Hypokalemia
Hypokalemia refers to a low level of potassium in the blood. It can cause muscle weakness, cramps, and arrhythmias, but it is not directly related to Kussmaul breathing. Hypokalemia can occur in diabetic ketoacidosis (DKA) due to the loss of potassium in urine, but it is not the primary cause of Kussmaul breathing. Kussmaul breathing is a deep, labored breathing pattern that occurs as a compensatory mechanism for metabolic acidosis, not directly due to low potassium levels.
Choice B reason: Metabolic Alkalosis
Metabolic alkalosis is a condition characterized by an elevated pH in body tissues due to an excess of bicarbonate or a loss of acid. It is the opposite of metabolic acidosis. Kussmaul breathing is specifically a response to metabolic acidosis, not alkalosis. Therefore, metabolic alkalosis is not related to Kussmaul breathing.
Choice C reason: Lipolysis
Lipolysis is the metabolic process of breaking down lipids (fats) into free fatty acids and glycerol. This process is accelerated in diabetic ketoacidosis (DKA) due to the lack of insulin, leading to the production of ketone bodies, which contribute to metabolic acidosis. While lipolysis is a part of the pathophysiology of DKA, it is not directly related to Kussmaul breathing. Kussmaul breathing is a compensatory mechanism for the acidosis caused by the accumulation of ketone bodies.
Choice D reason: Hyperglycemia
Hyperglycemia, or high blood sugar, is a hallmark of diabetic ketoacidosis (DKA). In DKA, the lack of insulin leads to elevated blood glucose levels and the breakdown of fats into ketones, causing metabolic acidosis. Kussmaul breathing is the body’s attempt to compensate for this acidosis by increasing the rate and depth of breathing to expel more carbon dioxide, thereby reducing the acidity of the blood. Therefore, hyperglycemia is directly related to the occurrence of Kussmaul breathing in DKA.
Correct Answer is B
Explanation
Choice A reason: Increased Serum Sodium
Increased serum sodium, or hypernatremia, is not consistent with SIADH. SIADH typically results in hyponatremia, which is a low level of sodium in the blood due to excessive water retention. The excess antidiuretic hormone (ADH) causes the kidneys to retain water, diluting the sodium in the bloodstream. Therefore, increased serum sodium is not a characteristic finding in SIADH.
Choice B reason: Decreased Serum Osmolality
Decreased serum osmolality is a hallmark of SIADH3. Serum osmolality measures the concentration of solutes in the blood. In SIADH, the excessive release of ADH leads to water retention, diluting the blood and lowering serum osmolality. This is a key diagnostic feature of SIADH and helps differentiate it from other conditions.
Choice C reason: Decreased Urinary Sodium
Decreased urinary sodium is not typically seen in SIADH. In fact, patients with SIADH usually have increased urinary sodium levels. This is because the kidneys excrete more sodium in an attempt to balance the excess water retained due to high ADH levels. Therefore, decreased urinary sodium is not consistent with SIADH.
Choice D reason: Decreased Urine Osmolality
Decreased urine osmolality is also not consistent with SIADH. In SIADH, urine osmolality is typically increased because the kidneys concentrate the urine due to the action of ADH. The high levels of ADH cause the kidneys to reabsorb water, resulting in more concentrated urine. Thus, decreased urine osmolality is not a characteristic finding in SIADH.
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