A nurse is assessing a child newly diagnosed with type 1 diabetes mellitus. Which of the following clinical manifestations should the nurse recognize as symptoms of diabetic ketoacidosis in this child? (Select all that apply)
Explanation & Rationale
A. Fruity (ketone) breath odor is correct because diabetic ketoacidosis (DKA) causes the production of ketone bodies, including acetone, which gives the breath a sweet, fruity odor. This is a classic and easily recognizable sign of DKA. B. Dehydration is correct because hyperglycemia leads to osmotic diuresis, causing excessive urination and fluid loss. Children with DKA often present with dry mucous membranes, poor skin turgor, tachycardia, and decreased urine output, all indicating dehydration. C. Hypotension without dehydration is incorrect because hypotension in DKA is typically secondary to dehydration and volume depletion. Hypotension in the absence of dehydration is not characteristic of DKA. D. Kussmaul respirations (deep, rapid breathing) are correct because metabolic acidosis in DKA stimulates the respiratory center to blow off excess carbon dioxide. These deep, labored respirations are a compensatory mechanism and are a hallmark sign of severe DKA. E. Weight gain is incorrect because children with DKA usually experience weight loss, not gain, due to fat and muscle breakdown, dehydration, and insulin deficiency.