Which laboratory finding confirms that a child with type 1 diabetes is experiencing diabetic ketoacidosis?

A. Hydralazine is incorrect because it is an antihypertensive used to lower blood pressure in preeclampsia or eclampsia, but it does not reverse magnesium sulfate toxicity, which is the immediate concern given the symptoms of respiratory depression, oliguria, and absent deep tendon reflexes.

B. Methylergonovine is incorrect because it is a uterotonic used to control postpartum hemorrhage. It is not indicated for magnesium toxicity and would not address the life-threatening respiratory and neuromuscular effects of magnesium sulfate overdose.

C. Calcium gluconate is correct because it is the antidote for magnesium sulfate toxicity. Symptoms of toxicity include respiratory depression (RR <12), oliguria (<30 mL/hr), absent deep tendon reflexes, and eventually cardiac arrhythmias or arrest. Administering 10 mL of 10% calcium gluconate IV over 3–5 minutes can rapidly reverse neuromuscular and cardiac effects while supportive care (e.g., stopping magnesium infusion and monitoring) is continued.

D. Narcan is incorrect because it is an opioid antagonist used to reverse opioid overdose. It has no effect on magnesium sulfate toxicity and would not address the neuromuscular or respiratory compromise in this patient.

A. Restrict the child's diet to low-calorie foods to prevent obesity is incorrect because children with cerebral palsy are at risk for undernutrition due to feeding difficulties and increased energy expenditure from spasticity. Restricting calories could impair growth and development rather than prevent obesity, so diet should focus on balanced nutrition and adequate caloric intake.

B. Encourage daily passive range-of-motion exercises is correct because spasticity and limited mobility in cerebral palsy can lead to contractures and joint deformities. Daily passive range-of-motion exercises help maintain joint flexibility, prevent contractures, promote circulation, and support functional mobility, which are critical in early intervention for children with cerebral palsy.

C. Avoid physical therapy until the child can walk independently is incorrect because delaying therapy misses a critical window for neurodevelopmental intervention. Early and consistent physical therapy is essential to maximize motor function, improve strength, and prevent complications, regardless of the child’s ability to walk independently.

D. Promote strict bed rest to prevent fatigue is incorrect because immobilization exacerbates muscle stiffness, spasticity, and joint contractures. Children with cerebral palsy benefit from structured activity and therapy, even if it induces mild fatigue, as this promotes motor skill development and overall function.