A client with type 1 diabetes has a blood glucose level of 620 mg/dL. What should the nurse monitor the client closely for?

In a client with type 1 diabetes presenting with a blood glucose level of 620 mg/dL, monitoring closely for metabolic acidosis is crucial. This condition can develop as a result of the body's inability to utilize glucose for energy due to insulin deficiency. Instead, the body begins to metabolize fatty acids, leading to the production of ketones, which can accumulate in the blood and result in metabolic acidosis.

It’s important to understand that at such high blood glucose levels, the risk of developing diabetic ketoacidosis (DKA) is also increased. However, DKA specifically refers to the combination of hyperglycemia, metabolic acidosis, and ketonuria, while metabolic acidosis can occur on its own as a consequence of the metabolic shifts occurring in the body.

Hyperglycemic shock is not a recognized clinical term for the direct consequences of high blood glucose, and hypoglycemic episodes would not be expected since the client is hyperglycemic. Therefore, while DKA is a critical condition to consider, metabolic acidosis directly addresses the physiological imbalances stemming from extremely high glucose levels, making it a primary concern in this scenario.

Monitoring for metabolic acidosis includes checking for signs such as Kussmaul respirations, fruity