When caring for the client with diabetic ketoacidosis (DKA), the nurse monitors the blood urea nitrogen (BUN) level for which of the following reasons?
1. Polyuria leads to dehydration and renal impairment.
2. Clients with DKA frequently develop chronic renal failure.
3. The BUN is frequently lower in clients with DKA than clients with HHNS.
4. Acidosis causes the BUN to elevate.
Polyuria leads to dehydration and renal impairment.
Rationale: The client with DKA experiences polyuria secondary to osmotic diuresis, causing fluid-volume deficit and decreased renal perfusion that will be reflected in an elevated BUN. Chronic renal failure is a long-term complication of diabetes, not acute. The BUN will not be lower in DKA than HHNS; both cause fluid deficit and will result in decreased renal perfusion. Acidosis does not directly affect the BUN; rather, it develops from lack of insulin to move glucose into the cell and break down fat for energy.
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