Which of the following is of primary importance for a child who is admitted to the PICU for DKA (diabetic ketoacidosis)?
Ensure IV fluid replacement is a hypertonic solution.
Assess for cardiac arrest related to high potassium levels.
Monitor the child's vital signs for hypertension.
Administer intravenous NPH insulin in high doses.
The Correct Answer is B
Choice A reason: IV fluid replacement in DKA is typically isotonic, not hypertonic, to avoid rapid changes in osmolality.
Choice B reason: This is correct. While the total body potassium is depleted in DKA, the initial lab values often show hyperkalemia (high potassium) due to the metabolic acidosis, which shifts potassium out of the cells. This can lead to serious cardiac dysrhythmias and even cardiac arrest, making continuous cardiac monitoring and potassium level assessment a top priority.
Choice C reason: Monitoring for hypertension is important, but the primary concern in DKA is managing the acidosis and hyperglycemia.
Choice D reason: This is incorrect. Treatment for DKA involves a continuous IV infusion of regular insulin at a low, steady rate, not high doses of NPH insulin. NPH insulin is an intermediate-acting insulin and is not suitable for the acute management of DKA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the correct choice. Enlarged painless, firm cervical lymph nodes are a classic sign of Hodgkin’s disease.
Choice B reason: A protuberant, firm abdomen is not a specific finding associated with Hodgkin’s disease.
Choice C reason: A soft to hard, nontender mass in the pelvic area could indicate various conditions but is not specific to Hodgkin’s disease.
Choice D reason: Painful lymph nodes are more commonly associated with infections, not Hodgkin’s disease.
Correct Answer is B
Explanation
Choice A reason: IV fluid replacement in DKA is typically isotonic, not hypertonic, to avoid rapid changes in osmolality.
Choice B reason: This is correct. While the total body potassium is depleted in DKA, the initial lab values often show hyperkalemia (high potassium) due to the metabolic acidosis, which shifts potassium out of the cells. This can lead to serious cardiac dysrhythmias and even cardiac arrest, making continuous cardiac monitoring and potassium level assessment a top priority.
Choice C reason: Monitoring for hypertension is important, but the primary concern in DKA is managing the acidosis and hyperglycemia.
Choice D reason: This is incorrect. Treatment for DKA involves a continuous IV infusion of regular insulin at a low, steady rate, not high doses of NPH insulin. NPH insulin is an intermediate-acting insulin and is not suitable for the acute management of DKA.
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