A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child?

Choice A: This statement indicates a lack of understanding of the teaching, as insulin should not be stored in the freezer, as freezing can damage the insulin and make it ineffective. Insulin should be stored in a cool and dry place, away from direct sunlight and heat sources. Unopened bottles of insulin can be stored in the refrigerator until their expiration date, but opened bottles of insulin can be kept at room temperature for up to 28 days.

Choice B: This statement indicates a lack of understanding of the teaching, as the morning blood glucose level for a child who has type 1 diabetes mellitus should be between 70 and 110 mg/dL, according to the American Diabetes Association. A blood glucose level between 90 and 130 mg/dL may indicate hyperglycemia, which is high blood sugar and can cause symptoms such as thirst, hunger, fatigue, or frequent urination. A blood glucose level below 70 mg/dL may indicate hypoglycemia, which is low blood sugar and can cause symptoms such as sweating, shaking, dizziness, or confusion.

Choice C: This statement indicates an understanding of the teaching, as eating a snack half an hour before playing soccer can help prevent hypoglycemia, which is low blood sugar, in a child who has type 1 diabetes mellitus. Physical activity can lower blood sugar levels by increasing the uptake of glucose by the muscles. Eating a snack that contains carbohydrates and protein can provide energy and prevent a sudden drop in blood sugar levels during or after exercise.

Choice D: This statement indicates a lack of understanding of the teaching, as regular insulin should not be skipped or stopped when a child who has type 1 diabetes mellitus is sick. In fact, insulin may need to be increased or adjusted when a child is sick, as illness can raise blood sugar levels by causing stress hormones or inflammation. The child should monitor their blood sugar levels more frequently when they are sick and follow their sick day plan that includes taking insulin, checking for ketones, staying hydrated, and contacting their provider if needed.

Choice A: Clubbing of the nail beds is not a finding that the nurse should expect in a child who has aortic stenosis, which is a condition that causes narrowing of the aortic valve and obstructs blood flow from the left ventricle to the aorta. Clubbing of the nail beds is a sign of chronic hypoxia, which can occur in conditions that affect the lungs or the right side of the heart.

Choice B: Murmur is a finding that the nurse should expect in a child who has aortic stenosis, as it indicates turbulent blood flow through the narrowed valve. A murmur can be heard with a stethoscope over the chest and may vary in intensity, pitch, and duration. A murmur caused by aortic stenosis is typically systolic, loud, and harsh and radiates to the neck or back.

Choice C: Weak pulses are a finding that the nurse should expect in a child who has aortic stenosis, as they indicate reduced blood flow and pressure in the peripheral arteries. Weak pulses can be felt with palpation of the radial, brachial, femoral, or pedal arteries and may be difficult to detect or absent.

Choice D: Bradycardia is not a finding that the nurse should expect in a child who has aortic stenosis, as it indicates a slow heart rate, which is less than 60 beats per minute in children. Bradycardia can occur in conditions that affect the electrical conduction system of the heart or cause increased vagal tone. A child who has aortic stenosis may have tachycardia, which is a fast heart rate, as a compensatory mechanism to increase cardiac output.

Choice E:Hypertension is not typically associated with aortic stenosis in children; instead, the condition often results in reduced blood pressure distal to the valve.