Diabetes Mellitus Q 2

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A client’s blood gases reflect diabetic acidosis. The nurse should expect:

  

    A. Increased pH

    B. Decreased PO2

    C. Increased PCO2

    D. Decreased HCO3

    

    

Correct Answer: D. Decreased HCO3

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The bicarbonate-carbonic acid buffer system helps maintain the pH of the body fluids; in metabolic acidosis, there is a decrease in bicarbonate because of an increase of metabolic acids. Acidosis in DKA is due to the overproduction of ?-hydroxybutyric acid and acetoacetic acid. At physiological pH, these 2 keto acids dissociate completely, and the excess hydrogen ions bind the bicarbonate, resulting in decreased serum bicarbonate levels.

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Option A: Due to carbon dioxide forming carbonic acid in the body when combining with water, the amount of carbon dioxide expired can cause pH to increase or decrease. If bicarbonate is reabsorbed and/or acid is secreted into the urine, the pH becomes more alkaline (increases).

Option B: If a PaO2 level is lower than 80 mmHg, it means that a person is not getting enough oxygen. A low PaO2 level can point to an underlying health condition, such as emphysema. chronic obstructive pulmonary disease, or COPD. pulmonary fibrosis.

Option C: PaCO2 level determines respiratory contribution; a high level means the respiratory system is lowering the pH and vice versa. Due to carbon dioxide forming carbonic acid in the body when combining with water, the amount of carbon dioxide expired can cause pH to increase or decrease.

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