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 A

Explanation

A. Wheezes are continuous, high-pitched musical sounds produced by the narrowing of airways, commonly heard in conditions like asthma. They occur mainly during exhalation and are indicative of airflow obstruction.
B. Stridor is a high-pitched, harsh sound that occurs during inspiration, often associated with an upper airway obstruction, such as laryngospasm or a foreign body.
C. Crackles are fine, crackling sounds heard during inspiration, typically due to fluid accumulation in the lungs (e.g., in pneumonia or heart failure).
D. Rhonchi are low-pitched, snoring sounds caused by the obstruction or narrowing of larger airways, often heard in conditions like chronic bronchitis, but they are not high-pitched like wheezes.

A. Moist mucous membranes B. Bounding peripheral pulses C. Urine specific gravity 1.002 D. Bradycardia

Correct Answer is C

Explanation

A. Moist mucous membranes: This is incorrect. In diabetes insipidus, the body loses large amounts of water due to a deficiency of antidiuretic hormone (ADH) or its effects. As a result, the client often experiences dehydration, leading to dry mucous membranes, not moist ones.
B. Bounding peripheral pulses: This is incorrect. While bounding pulses are often seen in conditions like fluid overload or hypervolemia, diabetes insipidus typically causes dehydration due to excessive urination, which would not lead to bounding pulses. The pulses would more likely be weak or thready due to fluid loss.
C. Urine specific gravity 1.002: This is the correct finding. In diabetes insipidus, the kidneys are unable to concentrate urine, resulting in very dilute urine. A urine specific gravity of 1.002 indicates very diluted urine, which is characteristic of diabetes insipidus.
D. Bradycardia: This is incorrect. Bradycardia (slow heart rate) is not typically associated with diabetes insipidus. In fact, tachycardia (increased heart rate) can occur as a compensatory response to dehydration caused by excessive urination in diabetes insipidus.

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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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