Pediatric Nursing Q 162
A child was brought to the emergency department with complaints of nausea, vomiting, fruity-scented breath. The resident on duty diagnosed the child with diabetes ketoacidosis. Which of the following should the nurse expect to administer?
A. Potassium chloride IV infusion.
B. Dextrose 5% IV infusion.
C. Ringer's Lactate.
D. Normal saline IV infusion.
Correct Answer: D. Normal saline IV infusion.
The initial priority in the treatment of diabetic ketoacidosis is the restoration of extracellular fluid volume through the intravenous administration of a normal saline(0.9 percent sodium chloride) solution. Treatment for DKA begins with ABCs and fluid resuscitation. Insulin therapy, usually by continuous infusion, can begin once the patient is stabilized.
Option A: This is not part of the initial treatment. Check potassium regularly (and other electrolytes) to avoid hypokalemia. Place patients on the cardiac monitor to observe early changes in the T-waves for early intervention. Most sources recommend obtaining serum potassium before any insulin dosing and replacing potassium if below 4.
Option B: Short-acting or Regular insulin should be administered as a continuous IV infusion to treat hyperglycemia and clear ketonemia. Bolus dosing of insulin has NO role in DKA treatment in children.
Option C: Dextrose solutions will be used only when the blood glucose level is decreased. IV fluids are given to treat shock, acidosis, and dehydration. Strict “ins and outs” fluid balance assessments should be kept.