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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Coughing indicates a normal protective mechanism when the toddler is attempting to dislodge and cough out the food.
B. Inability to speak is a significant sign of choking and indicates that the airway is nearly completely obstructed.
C. Gagging shows that the toddler is partially obstructed and still attempting to dislodge the food
D. Pulse of 100 Beats per minute is not a direct indicator of choking.
Correct Answer is C
Explanation
C. This statement emphasizes to the child that they are not responsible for the abuse they have experienced, helping to alleviate feelings of guilt or self-blame. This can provide validation and comfort to the child during a traumatic experience.
A. Involving the family in the discussion might not be appropriate if the family member is the perpetrator. The safety and well-being of the child should be the priority
B. This statement may make the child feel more isolated and conflicted about their feelings toward their family. It's important to acknowledge the abuse without placing blame or judgment on the family.
D. This statement undermines the nurse's duty to report suspected cases of child abuse to the appropriate authorities. Confidentiality cannot be guaranteed in cases of suspected abuse, as healthcare professionals are mandated reporters obligated to report any suspicions or evidence of abuse to protect the child's safety and well-being.
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