The client is admitted with metabolic acidosis secondary to diabetic ketoacidosis (DKA). Understanding metabolic acidosis, the nurse should choose which of the following as the priority nursing diagnosis?
  1. Decreased urinary elimination related to reduced output and muscle function.
  2. Decreased cardiac output related to fluid and electrolyte imbalance.
  3. Ineffective breathing pattern related to hyperventilation.
  4. Anxiety related to fears of long-term outcomes and discomfort.
Explanation
Answer - B - DKA is associated with excessive urine output, dehydration, and hypokalemia, placing the client at risk for decreased cardiac output and cardiac dysrhythmias. Choice A is false regarding output and does not address the metabolic pattern. Choices C and D may apply to the client, but are not the priority needs; in addition, Choice C will resolve as the DKA is treated.
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