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.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
A child with nephrotic syndrome is not infectious and therefore, does not pose a significant risk of infection to the child
A child recovering from a ruptured appendix may still carry an infection posing a risk of life threatening infection to the child with leukemia.
Although rheumatic fever occurs several days after the active streptococcal infection starts, a child with rheumatic fever still poses a risk of infection to the child with leukemia.
Correct Answer is A
Explanation
A 30-degree angle of elevation of the head of the bed is recommended for clients with spinal fusion surgery to help reduce pressure on the surgical site. It also promotes proper spinal alignment, and minimizes excessive strain on the surgical incision or spinal hardware displacement.
B. Protective isolation is not indicated for adolescents postoperative following scoliosis repair with Harrington rod instrumentation unless there are specific medical reasons, such as immunocompromised status.
C. Use of a PCA for pain management post spinal surgery is not appropriate. Other modes such oral should be explored for pain control
D. Log rolling is a technique used to safely reposition clients with spinal precautions to prevent twisting the spine.
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