A pediatric client is admitted to the hospital unconscious. The client has a history of type 1 diabetes, and according to the clients mother, has been to two birthday parties in the last few days and has resisted taking the prescribed insulin. At school the client had two more pieces of birthday cake and some ice cream at a class birthday party. What is the likely reason for this client's unconscious state?
Insulin shock
Metabolic ketoacidosis
Insulin reaction
Metabolic alkalosis
The Correct Answer is B
A. Insulin shock is another term for hypoglycemia, which would not cause unconsciousness after refusing insulin.
B. The history of missed insulin and high-carb intake suggests diabetic ketoacidosis (DKA), where lack of insulin leads to the breakdown of fats, creating ketones and resulting in unconsciousness.
C. An insulin reaction is hypoglycemia, which typically causes shakiness, sweating, and confusion, not unconsciousness after high-carb intake.
D. Metabolic alkalosis is unlikely in this case and is not related to missed insulin or high blood sugar.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Somnolence, hypotension, and oliguria are signs of decompensated shock, not compensated.
B. While irritability and tachypnea are early signs, hypotension indicates progression to decompensated shock.
C. Capillary refill time > 2 sec may occur in shock, but bradycardia is a late and ominous sign in pediatrics.
D. Irritability, tachycardia, and poor peripheral perfusion (e.g., delayed capillary refill, cool extremities) are hallmark signs of compensated shock, where the body is still maintaining blood pressure.
Correct Answer is C
Explanation
A. Cardiac arrhythmias can occur in Kawasaki disease, but they are not necessarily an indication of deterioration unless associated with significant clinical change.
B. Strep throat is unrelated to the progression of Kawasaki disease, though infection could complicate it.
C. Hypotension is a significant indicator of deterioration in Kawasaki disease, especially as it can signal cardiac involvement or shock.
D. Bradycardia is typically not a sign of deterioration in this condition, and it would need further evaluation.
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