Diabetic ketoacidosis is characterized by an increased level of ketone bodies, which causes metabolic acidosis. A patient in diabetic ketoacidosis will have an altered rate of ventilation. Will the patient be hyperventilating or hypoventilating? How will a change in the rate and depth of ventilation compensate for an acidosis that is metabolic in nature?

Elise Anderson is a 6-year-old girl who presents to the emergency department with a history of vomiting for the past 3 days. The nurse notices that her respiratory rate is abnormally low. What is the likely reason for this change in ventilation? Predict what Elise's arterial blood gas values would show.

Ms. Johanssen is a patient in the hospital. The nurse examines her laboratory reports and notices that she has developed hyperkalemia and acidosis over the past several days. On closer examination of her medical chart, the nurse also sees that her physician recently doubled her dose of spironolactone, an aldosterone-blocking diuretic. How does this explain her laboratory findings?

A laboratory printout of arterial blood gases indicates that a patient has an increased Pco₂ , decreased pH, and normal bicarbonate ion concentration. Is this patient in acidosis or alkalosis? Is the pH disturbance respiratory or metabolic in nature? Explain your reasoning. How long do you think the patient has had this pH disturbance? (Hint: Look at the bicarbonate ion concentration. What system controls the concentration of bicarbonate ions, and how quickly does it compensate for pH disturbances?)