CMSRN Medical-Surgical Nursing

Answer - A - When excessive quantities of fatty acids are oxidized, blood buffer systems may become exhausted. Ketoacidosis develops and acetone bodies are excreted in the urine. In an emergency room situation, diabetic acidosis can be recognized not only by increased rate and depth of respirations (Kussmaul’s respirations) but also by the odor of acetone on the breath. Neither osmotic diuresis (Choice B) nor failure in the sodium-hydrogen ion exchange (Choice C) causes acetonuria. In the latter case, failure to excrete excess hydrogen ions would decrease urinary acids. Volatile hydrogen ions (CO₂) are excreted by the lungs; a decrease in nonvolatile hydrogen ions in the glomerular filtrate (Choice D) would move the pH of the urine toward the alkaline side.