Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis?

Cerebral edema

Polyuria

Hypokalemia

Metabolic acidosis

Answer and Explanation

The Correct Answer is A

A. Cerebral edema is the most dangerous complication associated with the administration of hypotonic fluids in patients with diabetic ketoacidosis (DKA). This occurs because hypotonic fluids cause rapid shifts in fluid and electrolytes, which can lead to swelling of the brain, especially in children. The risk is heightened if fluids are replaced too quickly.
B. Polyuria is a common symptom of diabetic ketoacidosis due to high blood glucose levels and osmotic diuresis, but it is not caused by hypotonic fluid administration.
C. Hypokalemia is a potential risk in DKA but typically arises from the shift of potassium from the extracellular to intracellular space during treatment, especially with insulin administration, not from the use of hypotonic fluids.
D. Metabolic acidosis is a hallmark of diabetic ketoacidosis itself and is caused by the accumulation of ketones. It is not caused by hypotonic fluid replacement.

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Correct Answer is B

Explanation

A. Cheyne-Stokes breathing is characterized by periods of deep breathing followed by apnea and is often associated with conditions like heart failure or brain injury, not diabetic ketoacidosis (DKA).
B. Acetone odor to breath is a hallmark sign of diabetic ketoacidosis. The body breaks down fats for energy, producing ketones, which are released in the breath, giving it a fruity or acetone-like odor.
C. A blood glucose level below 40 mg/dL would indicate hypoglycemia, not DKA. In DKA, blood glucose levels are typically elevated (above 250 mg/dL).
D. Malignant hypertension refers to extremely high blood pressure with organ damage, and is not directly related to diabetic ketoacidosis.

A. Furosemide B. Methylprednisolone C. Epinephrine D. Dobutamine

Correct Answer is C

Explanation

A. Furosemide is a diuretic that is used to reduce fluid overload and manage conditions like heart failure or kidney disease. It is not indicated in anaphylaxis.
B. Methylprednisolone is a corticosteroid used for its anti-inflammatory properties and can be used in anaphylaxis to reduce inflammation and prevent delayed reactions. However, it is not the first-line treatment in acute anaphylactic shock.
C. Epinephrine is the first-line treatment for anaphylactic shock. It works by rapidly reversing the effects of anaphylaxis, such as bronchoconstriction, vasodilation, and edema, by stimulating alpha and beta receptors. Epinephrine should be administered as soon as anaphylaxis is suspected to stabilize the patient’s condition.
D. Dobutamine is a medication used to manage shock by increasing cardiac output, but it is not used in the management of anaphylactic shock. The priority is epinephrine to reverse the anaphylactic response.

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Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis?

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