What is a manifestation of diabetic ketoacidosis?

Diabetic ketoacidosis (DKA) occurs when insulin deficiency causes the body to break down fat for energy, producing ketone bodies as a byproduct. These ketones, which are acidic, accumulate in the blood and are excreted in the urine, resulting in ketonuria — a hallmark finding of DKA. The accumulation of ketoacids also causes a drop in blood pH, producing metabolic acidosis, not metabolic alkalosis. The body compensates for this acidosis through Kussmaul respirations — deep, rapid breathing — which eliminates carbon dioxide and reduces carbonic acid levels, resulting in respiratory alkalosis as a compensatory mechanism, not as a primary feature. However, the primary acid-base disturbance in DKA is metabolic acidosis, making respiratory alkalosis an incorrect answer as a manifestation of DKA itself. Hypoglycemia is the opposite of what occurs in DKA; clients in DKA typically present with significantly elevated blood glucose levels, often exceeding 250 mg/dL. Therefore, ketonuria is the correct answer as it directly reflects the pathophysiological process of DKA — fat catabolism producing ketone bodies that spill into the urine when renal threshold is exceeded.