Justine is admitted to the pediatric unit due to the occurrence of diabetic ketoacidosis signaling a new diagnosis of diabetes. The diabetes team explores the cause of the episode and take steps to prevent a recurrence. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?

Correct Answer: D

Rationale: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when there is not enough insulin in the body. In the absence of sufficient insulin, the body is unable to use glucose for energy, leading to the breakdown of fats for fuel. This results in the excessive production of ketone bodies, specifically acetoacetate and beta-hydroxybutyrate. As the ketone bodies accumulate in the blood, they lower the blood pH, leading to acidosis. This is what causes the characteristic symptoms of DKA, such as fruity breath, deep rapid breathing, and abdominal pain. Therefore, the excessive accumulation of ketone bodies from fat metabolism is the primary cause of diabetic ketoacidosis.

Correct Answer: B

Rationale: Coarctation of the aorta is a congenital heart defect where there is a narrowing of the aorta, usually near the insertion of the ductus arteriosus. This narrowing can lead to decreased blood flow to the lower body. A common finding in a child with coarctation of the aorta is absent or diminished femoral pulses due to the obstruction of blood flow through the narrowed aorta. Other symptoms may include high blood pressure in the arms, weak lower body pulses, and heart murmur. Squatting posture, severe cyanosis at birth, and cyanotic ("tet") episodes are not typically associated with coarctation of the aorta.

Correct Answer: B

Rationale: The Eustachian tubes are small passages that connect the middle ear to the back of the throat. In young children, these tubes are shorter, more horizontal, and more narrow than in adults, making them more prone to blockages and infections. When these tubes become blocked, usually due to factors like swelling from allergies or a cold, fluid can build up in the middle ear leading to otitis media or middle ear infection. Therefore, the anatomy and size of the Eustachian tubes play a significant role in the predisposition of children to otitis media.

Correct Answer: C

Rationale: Rheumatic fever is an inflammatory disease that can develop after an untreated or inadequately treated infection with group Aß-hemolytic streptococcus bacteria, particularly Streptococcus pyogenes. This bacteria causes strep throat, which if left untreated, can lead to complications such as rheumatic fever. Rheumatic fever primarily affects the heart, joints, skin, and brain. It is important to promptly treat streptococcal infections with antibiotics to prevent the development of rheumatic fever.

Correct Answer: A

Rationale: A neonate delivered by Cesarean section for a breech presentation is at higher risk for developmental dysplasia of the hips (DDH). Breech presentation, especially frank breech, increases the chance of hip instability and DDH due to the positioning of the legs in utero. DDH is a condition where the ball and socket joint of the hip does not properly form, leading to potential dislocation of the hip joint. It is important for the nurse to carefully assess the neonate for signs of hip dysplasia, such as limited hip abduction or asymmetry in the thigh folds, to facilitate early detection and intervention for optimal outcomes. Legg-Calve-Perthes (LCP), Duchenne muscular dystrophy (DMD), and slipped capital femoral epiphysis (SCFE) are not specifically related to breech delivery, and therefore, are less likely to be