What respiratory finding should a nurse expect in a school-age child with diabetic ketoacidosis?

In a school-age child with diabetic ketoacidosis (DKA), the presence of deep respirations, often referred to as Kussmaul respirations, is a hallmark finding. This respiratory pattern occurs as the body attempts to compensate for metabolic acidosis by expelling more carbon dioxide through increased depth and rate of breathing. In DKA, the accumulation of ketones in the blood leads to acidosis, prompting the respiratory system to respond by increasing ventilation to correct the pH imbalance.

Deep respirations characterized by an increased rate, typically around 32 breaths per minute in this scenario, indicate the body's effort to correct the acidotic state. This is a physiological response aimed at restoring homeostasis by diminishing the carbon dioxide levels in the blood.

Other respiratory patterns, such as shallow respirations, paradoxical breathing, or periods of apnea, would not be expected in this condition. Shallow breathing may indicate respiratory fatigue or distress, paradoxical breathing signifies severe compromise of respiratory mechanics, and apnea reflects a critical state that is not consistent with the compensatory mechanisms triggered by DKA. Hence, recognizing Kussmaul's respirations is crucial in anticipating and managing diabetic ketoacidosis effectively.