A 9-year-old child with type 1 diabetes is prone to having hypoglycemic episodes in the morning. Which intervention would be included in the school nurse's plan of care for this child?

Considering the presence of diabetes but treating the child the same as the other children

Limiting fluid intake during school hours

Asking the child each day what was eaten for breakfast

Checking several times a day for injuries because of participation in the physical education program

Answer and Explanation

The Correct Answer is C

Option A ("Considering the presence of diabetes but treating the child the same as the other children") is not the best approach because children with diabetes require individualized care and monitoring.

Option B ("Limiting fluid intake during school hours") is not an appropriate intervention and could potentially worsen the child's diabetes management. Hydration is important, and fluid intake should be based on the child's needs.

Option C. Asking the child each day what was eaten for breakfast.

Children with type 1 diabetes, especially those prone to morning hypoglycemic episodes, can benefit from close monitoring of their dietary choices and blood glucose levels. Asking the child what was eaten for breakfast allows the school nurse to assess whether the child had an appropriate meal and whether the insulin dosage may need adjustment. It helps identify potential factors contributing to hypoglycemia and provides valuable information for the child's diabetes management.

Option D ("Checking several times a day for injuries because of participation in the physical education program") is a good practice but does not specifically address the management of morning hypoglycemia. It is essential to monitor the child's safety during physical activities, but addressing breakfast choices and insulin management is more directly related to managing morning hypoglycemia.

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Correct Answer is D

Explanation

A. Administration of a systemic oral antibiotic and a topical antibiotic may be used, but this option does not address the removal of crusts, which is essential for preventing complications.

B. Administration of a systemic and a topical antifungal is not appropriate for impetigo, as impetigo is caused by bacteria, not fungi.

C. Using an oil-based soap for bathing is not recommended, as it may not effectively remove crusts and pustules associated with impetigo, and it does not have antimicrobial properties necessary for treatment.

D. Removal of crusts with an antimicrobial liquid.

Impetigo is a contagious bacterial skin infection, typically caused by Staphylococcus aureus or Streptococcus pyogenes. It often presents with crusts and pustules on the skin. To prevent complications, it's important to keep the affected areas clean and free from crusts. Gently removing crusts with an antimicrobial liquid and clean cloth helps prevent the spread of infection, allows topical antibiotics to work effectively, and reduces the risk of complications.

A. Place the infant in reverse Trendelenburg position B. Place the infant in the knee to chest position C. Take the infant's blood pressure in all extremities D. Notify the Physician

Correct Answer is C

Explanation

Option A (Place the infant in reverse Trendelenburg position) and option B (Place the infant in the knee to chest position) are not the immediate actions to address this situation. While these positions might be used in specific situations, assessing blood pressure is more appropriate in this context to evaluate for potential vascular issues.

Option C. Take the infant's blood pressure in all extremities.

In an infant with weaker femoral pulses compared to the brachial and radial pulses, there might be a concern about coarctation of the aorta (a narrowing of the aorta), which can affect blood flow to the lower extremities. To confirm this and assess for potential issues, taking blood pressure measurements in all four extremities is crucial. This comparison can help identify pressure differentials between the upper and lower extremities, which is a hallmark sign of coarctation of the aorta.

Option D (Notify the Physician) is generally a good step, but taking the blood pressure in all extremities should be done first to provide comprehensive information for the physician when discussing the infant's condition.

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A 9-year-old child with type 1 diabetes is prone to having hypoglycemic episodes in the morning. Which intervention would be included in the school nurse's plan of care for this child?

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