A client is concerned about complications associated with diabetes in children.
What should the nurse explain about the prevention of complications in children with diabetes mellitus?

Choice A rationale:

Genetic factors play a significant role in the development of diabetes mellitus, especially when there is a family history of the disease.

People with a family history of diabetes are at a higher risk of developing the condition due to the inheritance of certain genes that predispose them to diabetes.

These genetic factors can influence insulin production, insulin sensitivity, and glucose regulation.

The genetic component of diabetes is well-established, and research has identified specific genes associated with both type 1 and type 2 diabetes.

It's important to educate the client about the importance of monitoring their blood sugar levels and adopting a healthy lifestyle to reduce their risk, given their family history.

Choice B rationale:

Autoimmune destruction of beta cells is more associated with type 1 diabetes rather than a family history of the disease.

Type 1 diabetes is an autoimmune condition in which the body's immune system mistakenly targets and destroys the insulin-producing beta cells in the pancreas.

While this is a critical factor in type 1 diabetes, it is not typically linked to family history as a primary risk factor.

Choice C rationale:

Insufficient insulin is a consequence of diabetes rather than a risk factor.

In diabetes, the problem is usually related to the body's inability to produce enough insulin (in type 1 diabetes) or effectively use the insulin produced (in type 2 diabetes).

Insufficient insulin is a result of the disease, not a contributing factor related to family history.

Choice D rationale:

Lack of physical activity can be a risk factor for diabetes, especially type 2 diabetes, but it is not the primary factor associated with a family history of the disease.

Lack of physical activity may contribute to the development of diabetes in individuals who are already at risk due to genetic factors or other lifestyle-related factors.

It's essential to promote physical activity and a healthy lifestyle, but this is not the primary risk factor in the context of family history.

Choice A rationale:

A decrease in the child's blood glucose level from 300 mg/dL to 250 mg/dL would indicate an improvement in DKA.

This is because DKA is characterized by hyperglycemia, and a decrease in blood glucose levels shows that the insulin infusion is working to correct the high blood sugar.

The normal range for blood glucose levels in children is typically 70-140 mg/dL, so 250 mg/dL is still high but represents an improvement.

Choice B rationale:

A decrease in ketones in the urine is another positive sign in the management of DKA.

Ketones in the urine are a sign of metabolic acidosis, which is a hallmark of DKA.

A reduction in ketones indicates that the body is shifting away from using fats for energy and is starting to correct the metabolic derangement.

It's important to note that ketone levels are usually assessed qualitatively as negative, trace, small, moderate, or large, and a decrease from a higher level to a lower level is a positive sign.

Choice C rationale:

An increase in the respiratory rate is not typically an indicator of DKA improvement.

In fact, during DKA, the respiratory rate may increase as the body tries to compensate for the acidosis by blowing off carbon dioxide through rapid breathing.

Therefore, a further increase in respiratory rate may not necessarily be a sign of improvement.

Monitoring the respiratory rate is essential, but it doesn't directly indicate the resolution of DKA.

Choice D rationale:

An increase in pH is a significant indicator of DKA improvement.

In DKA, the blood becomes acidic due to the accumulation of ketones and the decreased pH levels.

An increase in pH levels suggests that the acidosis is being corrected, which is a positive sign in the management of DKA.

Normal blood pH levels for children typically range from 7.35 to 7.45.

Choice E rationale:

A decrease in bicarbonate levels is not a sign of DKA improvement.

In DKA, bicarbonate levels are typically low due to the acidosis.

As treatment progresses and the acidosis resolves, bicarbonate levels may start to increase, indicating improvement.

Therefore, a decrease in bicarbonate levels would not be a positive sign in this context.