Which of the following is of primary importance for a child who is admitted to the PICU for DKA (diabetic ketoacidosis)?
Ensure IV fluid replacement is a hypertonic solution.
Assess for cardiac arrest related to high potassium levels.
Monitor the child's vital signs for hypertension.
Administer intravenous NPH insulin in high doses.
The Correct Answer is B
Choice A reason: IV fluid replacement in DKA is typically isotonic, not hypertonic, to avoid rapid changes in osmolality.
Choice B reason: This is correct. While the total body potassium is depleted in DKA, the initial lab values often show hyperkalemia (high potassium) due to the metabolic acidosis, which shifts potassium out of the cells. This can lead to serious cardiac dysrhythmias and even cardiac arrest, making continuous cardiac monitoring and potassium level assessment a top priority.
Choice C reason: Monitoring for hypertension is important, but the primary concern in DKA is managing the acidosis and hyperglycemia.
Choice D reason: This is incorrect. Treatment for DKA involves a continuous IV infusion of regular insulin at a low, steady rate, not high doses of NPH insulin. NPH insulin is an intermediate-acting insulin and is not suitable for the acute management of DKA.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Explaining body changes to a toddler may not be effective due to their limited understanding at this developmental stage.
Choice B reason: Maintaining normal routines provides a sense of security and normalcy, which is crucial for a toddler's emotional well-being, especially during a serious illness.
Choice C reason: Allowing the child to talk about the illness can be therapeutic, but toddlers may not have the verbal skills to express complex emotions or understand their condition.
Choice D reason: While encouraging friends to visit can provide social support, it is not as fundamental as maintaining daily routines that offer stability in the child's life. Maintaining normal routines is the most comforting and beneficial intervention for a toddler in this situation.
Correct Answer is D
Explanation
Choice A reason: While headaches can be a symptom of high blood sugar, they are not as specific as other symptoms for diabetes.
Choice B reason: Asking about candy and sweets consumption is less relevant as type 1 DM is not caused by diet.
Choice C reason: Exercise is important for overall health but is not a diagnostic indicator of type 1 DM.
Choice D reason: This is the correct choice. Nocturia and bedwetting are common symptoms of type 1 DM due to excess urination caused by high blood sugar levels.
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