The family of a client who has a combined respiratory and metabolic acidosis as a result of bronchitis and diabetic ketoacidosis asks the nurse whether the client's confusion is likely to be permanent. What is the nurse's best response?
A. "It is too early to tell if the ketoacids will be permanently retained."
B. "Yes, although her memory will improve with time, some brain cell loss has oc-curred."
C. "Probably not. The confusion should clear as soon as her oxygen and electrolyte levels are normal."
D. "Probably not. The confusion should clear as soon as her pH and blood glucose levels are normal."
C
The pH abnormality alone is not responsible for the confusion. Most of the confusion is caused by the hypoxia in combination with the electrolyte imbalances that accompany severe, combined acidosis.
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