Question

The client with diabetes mellitus has a carbon dioxide level of \(46 \mathrm{mEq} / \mathrm{L}\). The nurse would expect to see which symptom is the client with a carbon dioxide level of \(46 \mathrm{mEq} / \mathrm{L}\) ? A. Kussmaul breathing B. Slow respirations C. Eupnea D. Absence of audible respirations

Short answer

A. Kussmaul breathing B. Slow respirations C. Eupnea D. Absence of audible respirations Answer: A. Kussmaul breathing

Step-by-step solution

Understanding Carbon Dioxide Levels and Its Impact

Start by understanding what are carbon dioxide (CO2) levels in the body and how it impacts the human body. The normal range for CO2 levels in the blood is between 23 to 29 milliequivalents per liter (mEq/L). When CO2 levels are high in the body, it leads to a condition called hypercapnia which can lead to respiratory acidosis.

Understanding Hypercapnia and Respiratory Acidosis

Hypercapnia and respiratory acidosis are conditions typically caused by poor ventilation which leads to an accumulation of CO2 in the body. The excess CO2 combines with water in the body to form carbonic acid hence increasing the body's acidity level and decreasing pH.

Identifying the symptom of High CO2 Levels

The symptoms of high CO2 levels in the body can vary but it often affects respiratory functioning and can manifest in different breathing patterns. Given the options in the exercise, the scenario describes a patient with Diabetes Mellitus and high CO2 level in the body. The key symptom that is a hallmark of high CO2 levels (Hypercapnia) in such a case is 'Kussmaul breathing'.

Understanding Kussmaul breathing

Kussmaul breathing is a deep and labored type of respiratory pattern often associated with severe metabolic acidosis, specifically diabetic ketoacidosis (DKA) but also kidney disease. It's a mechanism that the body employs in an attempt to decrease CO2 levels and increase oxygenation.

Final Analysis of the Symptom for the Case

Based on the data given - a patient with Diabetes Mellitus and CO2 levels of 46 mEq/L, one can state that the nurse should expect to see the symptom of Kussmaul breathing in such a patient since increase in CO2 levels correlates to respiratory acidosis, which often manifests as Kussmaul breathing, especially in a diabetic patient. Hence, The answer for this question should be option A. Kussmaul breathing.

Key concepts

Understanding Carbon Dioxide Levels in Blood

Carbon dioxide (CO2) is more than just a gas we exhale; it plays a critical role in the body's respiratory and metabolic processes. Normally, the levels of CO2 in the blood range between 23 to 29 mEq/L. These levels are tightly regulated by the body's respiratory system.

CO2 is produced as a waste product of metabolism and is transported in the blood to the lungs, where it is exhaled. When this balance is disrupted, and the CO2 levels rise above the normal range, a condition known as hypercapnia occurs. This can have a significant impact on the body's acid-base balance.

High levels of CO2 lead to an increased concentration of carbonic acid in the blood, which decreases the pH and results in a state of respiratory acidosis. Such a disturbance in the delicate equilibrium of blood gases and pH levels can be indicative of underlying health issues and requires careful monitoring and management by healthcare professionals.

Management of Hypercapnia

Hypercapnia, characterized by elevated CO2 levels in the blood, can be a serious medical condition necessitating prompt management. The first step in managing hypercapnia is to identify and treat the underlying cause, which might include diseases affecting the lungs or nervous system, drug overdoses, or severe infections.

Management strategies might include:

• Improving ventilation, using mechanical means if necessary.
• Administering supplemental oxygen.
• Ensuring that the airways are clear.
• Adjusting medications that might be causing respiratory depression.

Hypercapnia management aims to improve the patient's breathing and increase the removal of CO2 from the body. For chronic cases, long-term treatments such as lifestyle changes, breathing exercises, and nocturnal ventilation may be recommended to manage symptoms and improve quality of life.

Healthcare providers should carefully monitor CO2 levels and blood pH to ensure that treatments are effective and adjust them as needed.

Signs of Kussmaul Breathing

Kussmaul breathing is a distinctive respiratory pattern characterized by deep, labored breaths. It is often a sign of the body's attempt to correct a state of metabolic acidosis, such as that caused by diabetic ketoacidosis (DKA). In the case of high CO2 levels, this breathing pattern helps to expel CO2 in an effort to balance the body's pH levels.

Some signs of Kussmaul breathing include:

• Rapid, deep breaths.
• A 'sighing' characteristic to the breaths.
• No pause between the expiration and the next inspiration.

This type of breathing can be quite alarming to observe as it indicates a severe imbalance within the body requiring immediate medical attention. If Kussmaul breathing is present, it is crucial for healthcare providers to quickly assess and treat the underlying cause to prevent further complications associated with prolonged acidosis.