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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Ensure placement of the enteral tube with an abdominal x-ray:Verifying enteral tube placement is essential for safety, but it is not related to maintaining the newborn's growth and development. Tube placement should already have been verified prior to initiating feedings.
B. Speak to the healthcare provider about instituting physical therapy:Physical therapy may be beneficial for infants with specific motor delays, but it is not a routine intervention for all infants recovering from gastroschisis.
C. Offer a pacifier for non-nutritive sucking:Non-nutritive sucking (e.g., using a pacifier) is crucial for the growth and development of newborns, especially those unable to feed orally. It helps promote oral-motor development, soothes the infant, and lays the foundation for transitioning to oral feeding. This is particularly important for an infant receiving parenteral or enteral nutrition to ensure they develop the skills and comfort needed for future oral feeding.
D. Use sterile technique during feedings:Clean technique is generally sufficientor routine enteral feedings unless there is a specific indication for sterility (e.g., immunocompromised clients). Further, this does not directly support growth and development.
Correct Answer is D
Explanation
A. Documenting the client's relief of pain is important for the medical record but is not the first priority in this situation. The immediate concern is to determine the cause of the sudden pain relief and ensure the child's well-being.
B. Inquiring about the client's last meal is important for pre-operative considerations, but it is not the first action to take when sudden relief of abdominal pain is reported.
C. Giving prescribed intravenous antibiotics may be part of the treatment plan, but it should not be the first action when the child experiences sudden relief of abdominal pain. Contacting the healthcare provider to assess the situation is more urgent.
D Contact the healthcare provider.
In the case of a child diagnosed with appendicitis, sudden relief in abdominal pain can be concerning. This might indicate that the appendix has ruptured, leading to the spread of infection into the abdominal cavity, which can be a critical situation. It's essential for the healthcare provider to be informed immediately so they can assess the child's condition, order any necessary interventions, and potentially expedite the surgical procedure if required.
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