In a client with diabetic ketoacidosis (DKA), which nursing diagnosis is of highest priority at the time of assessment with reported frequent urination and thirst?

In a client experiencing diabetic ketoacidosis (DKA) with symptoms such as frequent urination and thirst, the highest priority nursing diagnosis is focused on addressing the deficient fluid volume related to osmotic diuresis.

In DKA, the body experiences a severe shortage of insulin, which leads to hyperglycemia. This high blood sugar causes osmotic diuresis, where excess glucose in the urine pulls water along with it, resulting in significant fluid loss. The frequent urination and thirst are direct consequences of this fluid loss, leading to dehydration, which can cause serious complications such as hypovolemic shock or organ failure if not addressed promptly.

Recognizing and prioritizing the nursing diagnosis of deficient fluid volume is crucial. It allows the healthcare team to focus on fluid resuscitation and interventions aimed at restoring the patient’s hydration status, which is essential for stabilizing the patient's condition. Monitoring vital signs, encouraging oral fluid intake if appropriate, and administering intravenous fluids as ordered are vital components of care to prevent further complications associated with dehydration.

Other diagnoses, while relevant, do not address the immediate risk of fluid loss as directly as the identification of deficient fluid volume does. For instance, imbalanced nutrition is indeed a concern in DKA due to