A nurse is caring for a school-age child who has full-thickness burns to 30% of the total body surface area (TBSA). The nurse is initiating the client's plan of care. Complete the following sentence by using the list of options.
The client is at highest risk for developing

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, evidenced by the client's

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.

Choice A reason: The posterior fontanel, which is the soft spot at the back of the infant's head, normally closes by 2 to 4 months of age. Therefore, the nurse should expect to find a closed posterior fontanel in a 6-month-old infant.

Choice B reason: Lateral incisors, which are the teeth on either side of the central incisors, normally erupt between 7 and 10 months of age. Therefore, the nurse should not expect to find lateral incisors in a 6-month-old infant.

Choice C reason: Sitting steadily without support is a developmental milestone that is usually achieved between 6 and 9 months of age. Therefore, the nurse may or may not expect to find this skill in a 6-month-old infant, depending on the individual variation.

Choice D reason: Using thumb and index fingers in a pincer grasp is a fine motor skill that is usually developed between 9 and 12 months of age. Therefore, the nurse should not expect to find this skill in a 6-month-old infant.

Choice A reason: Subcutaneous insulin is not the preferred route for a client with DKA, as it has a slower onset and peak than IV insulin. IV regular insulin is the preferred route, as it provides a rapid and continuous infusion of insulin that can be titrated according to the blood glucose level.

Choice B reason: IV regular insulin is the medication of choice for a client with DKA, as it lowers the blood glucose level and reverses the ketosis and acidosis. IV regular insulin has a rapid onset and peak, and can be adjusted based on the client's response.

Choice C reason: IV potassium chloride is indicated for a client with DKA, as the client is at risk of hypokalemia due to osmotic diuresis, insulin therapy, and metabolic acidosis. IV potassium chloride can prevent or treat hypokalemia and its complications, such as cardiac arrhythmias.

Choice D reason: Oxygen via nasal cannula is not necessary for a client with DKA, unless the client has signs of hypoxia or respiratory distress. The client's deep and rapid respirations are a compensatory mechanism for the metabolic acidosis, and do not indicate a need for oxygen therapy.

Choice E reason: Sodium bicarbonate is not recommended for a client with DKA, as it can cause paradoxical cerebral acidosis, hypokalemia, and impaired oxygen delivery. The client's acidosis can be corrected by IV insulin and fluid therapy, which will restore the normal metabolism of glucose and ketones.