Pediatric Diabetes Management for the NCLEX

Type 1 Diabetes in Children

Most common form in pediatrics. Autoimmune destruction of beta cells → absolute insulin deficiency. Onset can be sudden with DKA as the presenting event.

Signs of DKA in Children

• Kussmaul respirations (deep, rapid breathing)
• Fruity breath odor (ketones)
• Nausea, vomiting, abdominal pain
• Dehydration, altered consciousness
• Blood glucose >300, pH <7.30, positive ketones

DKA Management

1. IV fluid resuscitation (NS initially)
2. IV regular insulin drip (not SubQ during acute DKA)
3. Monitor potassium closely (insulin drives K+ into cells)
4. Monitor for cerebral edema - the most dangerous complication in pediatric DKA

Family Teaching

• Blood glucose monitoring technique and frequency
• Insulin administration, rotation of sites
• Recognize and treat hypoglycemia (15/15 rule)
• Sick day management - never skip insulin
• School management plan, MedicAlert bracelet
• Allow age-appropriate independence in self-care

Review Endocrine Disorders cheat sheet and Health Promotion study guide.