Which findings are typical in the secondary assessment of diabetes/renal failure?

• A. ABG: metabolic acidosis
• B. Urine output: decreased
• C. Glucose >160
• D. All of the above

Answer: (D)

In the secondary assessment of a patient with diabetes and renal failure, you’re looking for signs of metabolic imbalance and reduced kidney function. Metabolic acidosis on an arterial blood gas is common because kidney failure impairs acid excretion and bicarbonate reabsorption, and diabetes can contribute ketoacids, all of which lower pH and bicarbonate. Decreased urine output reflects the kidneys’ impaired filtration capacity, leading to oliguria in renal failure. Elevated blood glucose, such as a value over 160 mg/dL, is typical in diabetes and may persist or worsen with illness or renal impairment. Taken together, these findings—metabolic acidosis, reduced urine output, and hyperglycemia—are commonly seen in this patient population, making all of the above typical findings.