A 2-year old is admitted to the pediatric with acute onset of Type 1 diabetes mellitus and diabetic ketoacidosis. Diabetic ketoacidosis results from an excessive accumulation of which of the following?
Release of sodium bicarbonate from renal compensation
Ketone bodies from fat metabolism
Excretion of excess potassium from cellular death
Elevated glucose from elevated insulin
The Correct Answer is B
A. Release of sodium bicarbonate from renal compensation: In response to metabolic acidosis, the kidneys may attempt to compensate by excreting hydrogen ions and retaining bicarbonate ions. However, this mechanism does not contribute to the development of diabetic ketoacidosis.
B. Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus, particularly type 1 diabetes, resulting from a relative or absolute deficiency of insulin. In the absence of sufficient insulin, the body cannot properly utilize glucose for energy, leading to increased lipolysis (breakdown of fat) and subsequent production of ketone bodies (such as acetone, acetoacetate, and beta-hydroxybutyrate) as an alternative fuel source. The accumulation of ketone bodies in the blood lowers the blood pH, leading to metabolic acidosis characteristic of DKA.
C. Excretion of excess potassium from cellular death: Diabetic ketoacidosis can lead to electrolyte imbalances, including hyperkalemia due to shifts of potassium out of cells as acidosis worsens. However, this is a consequence of DKA rather than a primary cause.
D. In type 1 diabetes mellitus, there is an absolute deficiency of insulin, leading to hyperglycemia. Elevated glucose levels contribute to the osmotic diuresis seen in DKA, but they are not the primary cause of ketoacidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Gastritis is inflammation of the stomach lining and is typically not caused by streptococcal infections. There is no direct link between gastritis and rheumatic fever.
B. Rheumatic fever is an inflammatory condition that develops as a complication of inadequately treated Group A Streptococcus (GAS) infections such as strep throat.
Therefore, a history of a sibling having a sore throat 3 weeks ago is significant because it suggests a possible streptococcal infection.
C. Fifth disease, caused by parvovirus B19, is a viral infection that primarily affects children. It is not caused by streptococcal bacteria and is not associated with the development of rheumatic fever.
D. Chickenpox, caused by the varicella-zoster virus, is a viral infection and does not predispose a child to rheumatic fever.
Correct Answer is B
Explanation
To calculate the appropriate dosage of amoxicillin for the toddler; Given:
Weight of the toddler = 20 kg
Recommended dosage range = 20 to 25 mg/kg/day Calculate the total daily dose:
Minimum recommended dosage = 20 mg/kg/day Maximum recommended dosage = 25 mg/kg/day
Minimum total daily dose = 20 mg/kg/day × 20 kg = 400 mg/day Maximum total daily dose = 25 mg/kg/day × 20 kg = 500 mg/day
The prescribed dosage is 100 mg every 8 hours, which means 300 mg per day (100 mg × 3 times a day). As 300 mg is below the minimum recommended total daily dose (400 mg) for a toddler weighing 20 kg, the nurse should determine that the prescribed dosage is insufficient to achieve the desired effect.
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