A client in diabetic ketoacidosis has an elevated serum potassium ion (K+) level. The nurse explains to the client that this is caused by
a. bicarbonate loss in the urine instead of K+ loss.
b. binding of H+ to blood proteins.
c. increased reabsorption of K+ in the distal tubule of the nephron.
d. secretion by the kidneys of H+ and retention of K+.
D
In cases of serum H+ excess, more H+ is secreted by renal tubular cells, whereas K+ is retained, promoting hyperkalemia. Hyperkalemia also occurs because H+ and K+ exchange places in an attempt to maintain electroneutrality, with more H+ entering cells and more K+ leaving cells.
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