A nurse is caring for a 4-year-old child who has a new diagnosis of diabetes mellitus and is distressed after an insulin injection. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection?

A) Places the infant in a side-lying position:

Positioning is important in the care of an infant with myelomeningocele. The infant is usually placed in a prone (on the abdomen) position to prevent pressure on the sac and protect the neural tissue. Placing the infant in a side-lying position may not provide the needed protection.

B) Maintains a dry dressing over the sac:

This action indicates effective teaching. The sac should be covered with a sterile, non-stick dressing to protect the exposed neural tissue from infection and trauma. Keeping the dressing dry is important to prevent complications

C) Performs range of motion on the infant's hips:

Range of motion exercises are not typically performed on the hips of an infant with myelomeningocele. The focus of care is primarily on protecting the exposed neural tissue, preventing infection, and ensuring proper positioning.

D) Takes an axillary temperature:

Taking an axillary temperature is a common method for measuring an infant's body temperature. However, in the case of an infant with myelomeningocele, it's important to avoid any pressure or friction on the sac area. The nurse should use care to prevent disturbing the dressing or causing discomfort to the infant.

A) Heat intolerance.

Explanation: This statement is true. Heat intolerance is a common symptom of hyperthyroidism, including Graves' disease. People with hyperthyroidism often have an overactive thyroid gland that produces an excessive amount of thyroid hormones. This can lead to an increased metabolic rate, which in turn makes them sensitive to heat. They may feel excessively warm, sweat more than usual, and have difficulty tolerating hot weather.

B) Weight gain.

Explanation: This statement is false. Weight gain is not a typical finding in Graves' disease or hyperthyroidism. In fact, one of the hallmark symptoms of hyperthyroidism is unexplained weight loss despite increased appetite. The elevated levels of thyroid hormones cause an increase in metabolism, leading to weight loss.

C) Bradycardia.

Explanation: This statement is false. Bradycardia refers to an abnormally slow heart rate, typically below 60 beats per minute. In hyperthyroidism, the heart rate is often elevated rather than slowed down. The excessive thyroid hormones can lead to an increased heart rate (tachycardia) and palpitations. It's important to note that if the question were about hypothyroidism (underactive thyroid), bradycardia might be more relevant.

D) Lethargy.

Explanation: This statement is false. Lethargy, or a state of extreme tiredness and lack of energy, is more commonly associated with hypothyroidism (underactive thyroid) rather than hyperthyroidism. Hyperthyroidism usually leads to symptoms of increased energy, restlessness, and hyperactivity due to the elevated metabolic rate caused by excess thyroid hormones.