A client with DKA asks a nurse why potassium replacement is necessary during treatment.
The nurse should explain that:.

A. "Evaluate the child's emotional well-being.”.

D. "Obtain a detailed history, including family history of diabetes.”.

E. "Regularly monitor blood glucose levels to assess glycemic control.”.

Choice A rationale:

Evaluate the child's emotional well-being.

Assessing the emotional well-being of a child with diabetes is crucial because living with a chronic condition can have a significant impact on a child's mental health.

Children may experience stress, anxiety, and other emotional challenges related to their condition.

This assessment helps in providing comprehensive care and support to the child.

Choice B rationale:

Assess for signs of hyperglycemia, such as polyuria.

While assessing for signs of hyperglycemia, such as polyuria, is important in managing diabetes, it is primarily a physical assessment and not a psychosocial assessment.

It focuses on the physiological aspects of the condition.

Choice C rationale:

Monitor growth patterns and assess for any delays.

Monitoring growth patterns and assessing for delays in a child's development is important but is also primarily a physical assessment.

It is not a direct component of the psychosocial assessment, although it may indirectly impact a child's emotional well-being.

Choice D rationale:

Obtain a detailed history, including family history of diabetes.

Obtaining a detailed history, including a family history of diabetes, is a crucial part of the assessment.

Family history can be a significant risk factor for the development of diabetes in a child.

Understanding the family history helps in identifying potential genetic predispositions.

Choice E rationale:

Regularly monitor blood glucose levels to assess glycemic control.

Regularly monitoring blood glucose levels is essential in managing diabetes.

While it is a key aspect of diabetes care, it primarily falls under the category of physiological monitoring rather than a direct component of psychosocial assessment.

Choice A rationale:

In DKA management, insulin is typically administered intravenously as a continuous infusion.

This approach allows for precise control of insulin delivery, making it possible to titrate the insulin dose according to the patient's response.

Intravenous insulin is preferred because it provides rapid onset and offset of action and can be adjusted as needed to address changes in the patient's condition.

Choice B rationale:

Administering insulin as a single, large dose is not the standard practice in DKA management.

Large bolus doses of insulin can lead to rapid reductions in blood glucose levels, potentially causing hypoglycemia.

Continuous intravenous infusions are favored for gradual correction of hyperglycemia while avoiding rapid fluctuations in blood glucose levels.

Choice C rationale:

Oral insulin is not preferred for the treatment of DKA.

In this acute condition, the absorption of oral medications can be unpredictable and slow, which may not provide the rapid and consistent control of blood glucose levels required in DKA management.

Choice D rationale:

Insulin injections are typically given subcutaneously for routine diabetes management, but in the case of DKA, intravenous administration is the preferred route.

Subcutaneous injections have a slower onset of action and may not be suitable for addressing the acute and severe hyperglycemia characteristic of DKA.