A nurse is reviewing the laboratory report of a client who has diabetic ketoacidosis (DKA) Which of the following findings should the nurse expect?

Serum glucose 600 mg/dL.

Serum bicarbonate 28 mEq/L.

Serum potassium 2.5 mEq/L.

Serum sodium 150 mEq/L.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Serum glucose 600 mg/dL. This is an expected finding for a client who has diabetic ketoacidosis (DKA) DKA results from a deficiency of insulin, which leads to hyperglycemia and ketosis. The normal range for serum glucose is 70 to 110 mg/dL.

Choice B reason:

Serum bicarbonate 28 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences ketosis, which results in ketones in the urine and blood. The nurse should expect a client who has DKA to have an HCO3- less than 15 mEq/L. This decreased value is due to an increased production of ketones, which results in metabolic acidosis. The normal range for serum bicarbonate is 22 to 26 mEq/L.

Choice C reason:

Serum potassium 2.5 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences osmotic diuresis and subsequent dehydration, which can cause electrolyte imbalances. The nurse should expect a client who has DKA to have elevated serum potassium levels due to the movement of potassium from the intracellular to the extracellular space in response to acidosis. The normal range for serum potassium is 3.5 to 5 mEq/L.

Choice D reason:

Serum sodium 150 mEq/L. This is not an expected finding for a client who has DKA. A client who has DKA experiences osmotic diuresis and subsequent dehydration, which can cause electrolyte imbalances. The nurse should expect a client who has DKA to have decreased serum sodium levels due to the dilutional effect of excess glucose in the blood. The normal range for serum sodium is 136 to 145 mEq/L.

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Correct Answer is B

Explanation

Choice A reason:

Crystalloid solutions are fluids that contain electrolytes and can diffuse across semipermeable membranes. They are used to treat dehydration, electrolyte imbalances, and hypovolemia. However, they are not as effective as colloids in expanding the intravascular volume and maintaining the blood pressure. Therefore, choice A is incorrect.

Choice B reason:

Colloid solutions are fluids that contain large molecules such as proteins, starches, or gelatin that cannot cross the capillary membrane. They exert an osmotic pressure that draws fluid from the interstitial and intracellular spaces into the intravascular space. They are used to treat hypovolemic shock, burns, and hemorrhage. Albumin is a type of colloid solution that is derived from human plasma and contains 5% or 25% protein. It increases the plasma volume and the blood pressure by increasing the oncotic pressure. Therefore, choice B is correct.

Choice C reason:

Hypertonic solutions are fluids that have a higher osmolarity than the blood plasma. They draw water out of the cells and into the intravascular space. They are used to treat hyponatremia, cerebral edema, and severe dehydration. However, they can cause fluid overload, hypertension, and cellular dehydration if given in excess. Therefore, choice C is incorrect.

Choice D reason:

Hypotonic solutions are fluids that have a lower osmolarity than the blood plasma. They provide free water and electrolytes to the cells and the interstitial space. They are used to treat hypernatremia, cellular dehydration, and fluid loss due to burns or diuresis. However, they can cause fluid shifts from the intravascular space to the interstitial and intracellular spaces, resulting in hypovolemia, hypotension, and edema. Therefore, choice D is incorrect.

A. Serum sodium. B. Serum potassium. C. Serum chloride. D. Serum bicarbonate.

Correct Answer is D

Explanation

Choice A reason:

Serum sodium is not directly related to the acid-base balance of the body. Sodium bicarbonate therapy does not affect the serum sodium level significantly. Therefore, monitoring serum sodium is not an effective way to evaluate the effectiveness of the therapy.

Choice B reason:

Serum potassium is inversely related to the serum pH. As the pH increases, the potassium level decreases, and vice versa. Sodium bicarbonate therapy raises the pH and lowers the potassium level. Therefore, monitoring serum potassium is important to prevent hypokalemia, but it does not directly reflect the acid-base balance of the body.

Choice C reason:

Serum chloride is inversely related to the serum bicarbonate level. As the bicarbonate level increases, the chloride level decreases, and vice versa. Sodium bicarbonate therapy increases the bicarbonate level and decreases the chloride level. Therefore, monitoring serum chloride is important to prevent hypochloremia, but it does not directly reflect the acid-base balance of the body.

Choice D reason:

Serum bicarbonate is directly related to the acid-base balance of the body. The normal range of serum bicarbonate is 22 to 26 mEq/L. In metabolic acidosis, the bicarbonate level is low, and in metabolic alkalosis, it is high. Sodium bicarbonate therapy aims to increase the bicarbonate level and correct metabolic acidosis. Therefore, monitoring serum bicarbonate is the most effective way to evaluate the effectiveness of the therapy.

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A nurse is reviewing the laboratory report of a client who has diabetic ketoacidosis (DKA) Which of the following findings should the nurse expect?

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