Parents of a school-age child with hemophilia ask the nurse, “What sport is recommended for children with hemophilia?” Which sport should the nurse recommend?

Choice A reason:

Extracellular hyperglycemia refers to high blood sugar levels outside the cells. While hyperglycemia is a common feature of diabetic ketoacidosis (DKA), it is not the direct cause of the condition. DKA occurs when the body cannot use glucose for energy due to a lack of insulin, leading to the breakdown of fat and protein for energy, which produces ketones and causes acidosis.

Choice B Reason:

Hypoglycemia, or low blood sugar, is not associated with diabetic ketoacidosis. In fact, DKA is characterized by high blood sugar levels. Hypoglycemia is a separate condition that can occur in individuals with diabetes, particularly if they take too much insulin or skip meals.

Choice C Reason:

The use of fat and protein as an energy source is the primary mechanism behind diabetic ketoacidosis. When insulin is deficient, the body cannot utilize glucose for energy. As a result, it breaks down fat and protein to produce energy. This process generates ketones, which are acidic and lead to the development of ketoacidosis.

Choice D Reason:

Increased cellular metabolism of glucose is not related to diabetic ketoacidosis. In DKA, the problem is that cells cannot use glucose effectively due to a lack of insulin. Instead, the body resorts to breaking down fat and protein for energy, leading to the production of ketones and acidosis.

Choice A reason:

Assessing fluid intake is important in managing dehydration, but it is not the most critical assessment before initiating an IV infusion containing potassium chloride (KCL). Fluid intake provides information about the child’s hydration status but does not directly indicate kidney function. Since potassium can cause hyperkalemia if not properly excreted, monitoring urine output is more crucial.

Choice B reason:

Urine output is the most important assessment before initiating an IV infusion containing potassium chloride (KCL). This is because adequate urine output indicates that the kidneys are functioning properly and can excrete excess potassium. Administering potassium chloride without ensuring proper kidney function can lead to hyperkalemia, a potentially life-threatening condition. Therefore, checking urine output is essential to prevent complications.

Choice C reason:

Capillary refill is a useful assessment for evaluating peripheral perfusion and hydration status. However, it does not provide direct information about kidney function or the body’s ability to excrete potassium. While capillary refill can be part of the overall assessment, it is not the most critical factor before administering an IV infusion with potassium chloride.

Choice D reason:

The number of stools is relevant in assessing dehydration, especially if the child has been experiencing diarrhea. However, like fluid intake, it does not directly indicate kidney function. Monitoring urine output is more important before administering potassium chloride to ensure the kidneys can handle the additional potassium load.