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.

Answer and Explanation

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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Correct Answer is C

Explanation

Choice A reason: This statement is incorrect; children's bones actually heal faster than those of adults due to a more robust blood supply and the presence of growth factors.

Choice B reason: Growth in children does not occur due to an increase in the number of muscle fibers; rather, it happens through the lengthening of existing fibers.

Choice C reason: Children's bones do have decreased density compared to adults, which is why they are more flexible and less likely to break.

Choice D reason: The statement about decreased blood flow in children's bones is incorrect; children typically have a higher blood flow in their bones, which contributes to their faster healing process.

A. Administer non-opioid analgesics. B. Use guided imagery to prepare the child for painful procedures. C. Suggest diversional activities, such as coloring. D. Request an order to start an IV PCA.

Correct Answer is D

Explanation

Choice A reason: Non-opioid analgesics are typically not strong enough to manage the severe pain associated with a sickle cell crisis.
Choice B reason: Guided imagery can be a helpful adjunct, but it is not the primary method of pain control during a crisis.
Choice C reason: Diversional activities may help distract from the pain but are not sufficient as the sole method of pain management.
Choice D reason: This is the correct choice. An IV PCA (patient-controlled analgesia) allows the child to manage pain effectively and is appropriate for severe pain during a sickle cell crisis.

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Which of the following is of primary importance for a child who is admitted to the PICU for DKA (diabetic ketoacidosis)?

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Naxlex Comprehensive Predictor Exams

Which statement is accurate concerning a child's musculoskeletal system and how it differs from that of an adult?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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