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
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Correct Answer is A
Explanation
When assesssing the child with suspected or confirmed Wilm's tumor, it is important to avoid palpation of the abdomem. This is because it can lead to dislodging of the tumor cells
Correct Answer is A
Explanation
A. Monitoring the child's blood count is essential to assess the effectiveness of the iron supplements and ensure the child's anemia is being treated properly.
B. Dietary fiber does not enhance iron absorption; in fact, high levels of fiber can inhibit the absorption of iron. It is generally recommended to maintain a balanced diet while taking iron supplements.
C. Iron supplements are best absorbed on an empty stomach. However, if they cause stomach upset, they may be taken with a small amount of food or as directed by a healthcare provider.
D. Iron supplements should be administered in divided doses throughout the day to enhance absorption and minimize gastrointestinal side effects.
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