The ED nurse is caring for a client with type 1 diabetes who was brought in by ambulance after losing consciousness. Upon assessment, the client's breath was noted to be fruity. Which of the following ABG results would the nurse expect?


• This patient is in Diabetic ketoacidosis, as evidenced by the low pH (acidosis) and the low HCO3. Bicarb is used to compensate for the build-up of beta-hydroxybutyric and acetoacetic acids/ketoacids caused by the DKA.   

• The PCO2 will be high (if uncompensated) or low (if the lungs are compensating with classic Kussmaul respirations to blow off CO2).

• This finding is also supported by the history of type 1 diabetes, the fact the client was found unconscious, and the fruity breath.

Metabolic Acidosis:
• Caused by loss of bicarb or a buildup of acids (lactic acidosis, diarrhea, renal failure, ketones, or ammonium intoxication), not caused by respiration.
• HCO3 decreases, pH decreases
• Compensation- hyperventilation to eliminate CO2

Respiratory Acidosis:
• Respiratory system is the cause
• Increase in PCO2, decrease in pH
• Compensation- kidneys reabsorb Bicarb (HCO3)

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