A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment is most important for the nurse to obtain?

Understanding of quality control process used to troubleshoot the pump.

Interpretation of fingerstick glucose levels that influence diet selections.

Knowledge of her glycosylated hemoglobin A1c levels for past year.

Ability to program the pump for basal insulin with mealtime boluses.

Answer and Explanation

The Correct Answer is D

A. Understanding the quality control process used to troubleshoot the pump is important, but it is a secondary assessment and educational component. The primary focus should be on the child's ability to operate the pump effectively.

B. Interpretation of fingerstick glucose levels is important for diabetes management, but it does not specifically address the use of an insulin pump.

C. Knowledge of glycosylated hemoglobin A1c levels is valuable for assessing long-term glycemic control but is not the primary assessment needed when considering the transition to an insulin pump.

D Ability to program the pump for basal insulin with mealtime boluses.

When a child with type 1 diabetes mellitus expresses an interest in using an insulin pump, the most important assessment is their ability to program and manage the pump effectively. The nurse should assess whether the child and their family have the knowledge and skills to use the pump, including setting basal insulin rates and delivering mealtime boluses. The successful use of an insulin pump requires a good understanding of its operation and the ability to make adjustments based on the child's specific needs and glucose levels.

The ability to manage the insulin pump effectively is essential to ensure safe and appropriate diabetes management, making it the most important assessment in this context.

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Correct Answer is D

Explanation

A. Giving the injection in the arm, one to 2 inches below the acromion process, is a technique typically used for adults or older children. It may not be suitable for a toddler of this age.

B. Using a needle length of 1/2 inch is not appropriate for intramuscular injections in a toddler. It may not reach the muscle tissue, leading to ineffective administration.

C. Dividing the gluteal area into quarters and giving the injection into the upper outer quadrant is a technique typically used for older children and adults, not for toddlers. It's also important to avoid intramuscular injections in the gluteal area for young children due to the risk of injury to the sciatic nerve.

D. Administering the injection into the middle of the lateral aspect of the thigh is the preferred technique for intramuscular injections in toddlers. The thigh muscles are a safe and effective site for IM injections in this age group. The middle of the lateral aspect of the thigh is commonly chosen because it provides a sufficient muscle mass for proper absorption of the medication and minimizes the risk of injury to nerves or vessels. This technique is recommended for toddlers who are walking and have developed sufficient muscle mass in the thigh area.

A. Ibuprofen should be used prophylactically to prevent febrile seizures. B. Reassure the parents that febrile seizures decrease as the child grows older. C. Avoid excessive visual stimuli because it can precipitate seizure activity. D. Provide the child with a sponge bath for temperatures over 100.6° F (38.1° C)

Correct Answer is B

Explanation

A. Using ibuprofen prophylactically to prevent febrile seizures is not a standard approach and is not generally recommended. The focus should be on managing the child's fever with appropriate fever-reducing medications rather than attempting to prevent febrile seizures with medication.

B. Reassure the parents that febrile seizures decrease as the child grows older.

Febrile seizures are relatively common in young children and are typically associated with rapid increases in body temperature, often due to infections.

The most important information to convey to the parents is that febrile seizures are usually a benign and self-limited condition, and they tend to decrease in frequency and may even resolve as the child grows older. Reassuring parents about the natural course of febrile seizures is vital to alleviate their concerns. However, it's essential to educate them on fever management and when to seek medical attention for their child's febrile seizures.

C. Avoiding excessive visual stimuli is not a standard recommendation for preventing febrile seizures. Febrile seizures are primarily related to fever and not visual stimuli.

D. Providing a sponge bath for temperatures over 100.6° F (38.1° C) can help reduce fever, but it is not directly related to preventing febrile seizures. The main goal in such situations is to manage the fever itself.

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A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment is most important for the nurse to obtain?

Nursing Test Bank

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