A client is admitted to the intensive care unit with diabetic ketoacidosis. The client is most likely to exhibit which of the following arterial blood gas results?

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11ecbb05_caf9_c66f_b433_adcbece354e3_MD0009_00 The arterial blood gas (ABG) result most consistent with the diagnosis of diabetic ketoacidosis (DKA) is metabolic acidosis or partially compensated metabolic acidosis (pH 7.30, PaCO₂ 30 mm Hg [4.0 kPa], HCO₃ 15 mEq/L [15 mmol/L]). DKA is a life-threatening complication of type 1 diabetes characterized by hyperglycemia (>250 mg/dL [13.9 mmol/L]) resulting in ketosis, a metabolic acidosis. Glucose cannot be taken out of the bloodstream and used for energy without insulin, which individuals with type 1 diabetes cannot produce. Similar to a state of starvation, the body begins to break down fat stores into ketones, causing a metabolic acidosis (low pH and low HCO3). As a compensatory mechanism, this client has deep and rapid respirations with fruity/acetone smell (Kussmaul respirations) in an attempt to reduce carbon dioxide levels by inducing a respiratory alkalosis to partially compensate for the ketoacidosis, which has nearly normalized the pH. (Option A) This is an example of respiratory acidosis (low pH and increased CO₂ levels). It is commonly seen in conditions that cause CO₂ retention (eg, chronic obstructive pulmonary disease, obesity hypoventilation syndrome, respiratory depression due to narcotics). (Option C) This is an example of normal ABG results. (Option D) This is an example of metabolic alkalosis (high pH and elevated HCO₃), which typically presents with prolonged vomiting and aggressive diuresis. Educational objective: The arterial blood gas result most consistent with the diagnosis of diabetic ketoacidosis is metabolic acidosis or partially compensated metabolic acidosis (pH ≤7.30 and HCO₃ ≤18 mEq/L [18 mmol/L]). Respiratory compensation may raise pH to near-normal values, but the PCO₂ will be dramatically lower than normal (PCO₂ ≤30 mm Hg [4.0 kPa]).

A Client Is Admitted to the Intensive Care Unit with Diabetic