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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the correct choice. Hypopituitarism often results in short stature due to a deficiency in growth hormone.
Choice B reason: Precocious puberty is not typically associated with hypopituitarism; it is more often related to excess hormone production.
Choice C reason: Progressive linear growth retardation after normal growth in the first five years is not characteristic of hypopituitarism.
Choice D reason: While stunted growth can occur, hypopituitarism specifically affects height due to growth hormone deficiency, and weight may not be equally affected.
Correct Answer is D
Explanation
Choice A reason: A high-pitched cry can be a sign of distress in an infant, but it is not a specific indicator of increased intracranial pressure. It could be due to a variety of reasons, including discomfort, hunger, or other forms of distress.
Choice B reason: Decreased lower extremity movement could be a sign of a neurological issue, but it is not a direct indicator of increased intracranial pressure. It would require further evaluation to determine the cause.
Choice C reason: Excessive wet diapers are not typically associated with increased intracranial pressure. This symptom could be related to other conditions such as diabetes insipidus or excessive fluid intake.
Choice D reason: This is the correct choice. A bulging fontanel when crying is a classic sign of increased intracranial pressure in an infant. The fontanel, or soft spot on the baby's head, can bulge when there is increased pressure within the skull. This should be promptly evaluated by a healthcare professional.
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