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 story book about a child who has diabetes

A period of play in the playroom

A needleless syringe and a doll

A video game

Answer and Explanation

The Correct Answer is C

A) A story book about a child who has diabetes:

While a story book about a child with diabetes can be informative and reassuring, it might not directly address the child's distress after an insulin injection. The child needs an interactive play activity that mimics the experience to help them cope with the distress.

B) A period of play in the playroom:

Playing in a general playroom might be enjoyable, but it may not directly address the child's specific distress related to the insulin injection. To address the distress, a play activity directly related to the injection experience is more appropriate.

C) A needleless syringe and a doll.

Explanation:

Using a needleless syringe and a doll allows the child to engage in therapeutic play that simulates the experience of receiving an insulin injection. This type of play, known as medical play or therapeutic medical play, allows children to gain a sense of control and understanding over medical procedures in a non-threatening and imaginative way. By allowing the child to "give" the doll an injection using the needleless syringe, the child can process their feelings and fears related to their own injections, helping to reduce anxiety and distress.

D) A video game:

Playing a video game can be engaging and distracting, but it doesn't directly help the child process their feelings or fears about the insulin injection. Therapeutic play involving a needleless syringe and a doll provides a more hands-on and interactive way for the child to work through their emotions.

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Correct Answer is B

Explanation

A. Maintain a saline-lock:

Maintaining a saline lock is important for potential intravenous access, but it is not the most urgent priority compared to actions that directly monitor the child's condition and help manage the disease.

B. Check the child's daily weight:

Monitoring daily weight is crucial in acute glomerulonephritis, as it helps assess fluid balance and detect early signs of fluid retention or worsening kidney function, which are key concerns in this condition. This makes it a priority action.

C. Place the child on a no-salt-added diet:

While dietary modifications can be important for managing various health conditions, including kidney issues, this is not the top priority in this situation. Reducing salt intake can help manage fluid retention, but it is not the nurse's priority action at this moment.

D. Educate the parents about potential complications:

Patient education is crucial, especially in chronic conditions, but in this acute care scenario, the nurse's immediate priority is to address the child's needs. Educating parents about potential complications should be done, but it's not the most immediate action.

A. Obtain an influenza vaccine annually B. Take glyburide with breakfast C. Administer glucagon for hyperglycemia D. Inject insulin in the deltoid muscle

Correct Answer is A

Explanation

Type 1 diabetes mellitus is a condition where the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Individuals with type 1 diabetes require insulin therapy to manage their blood sugar levels. Since the question is about teaching an adolescent with type 1 diabetes, let's analyze each option:

A) Obtain an influenza vaccine annually:

This is a crucial recommendation. People with diabetes, including type 1 diabetes, have a higher risk of complications from infections, including influenza (the flu). The flu can lead to elevated blood sugar levels and potentially worsen diabetes control. Getting an annual influenza vaccine helps reduce the risk of getting the flu and its associated complications.

B) Take glyburide with breakfast:

Glyburide is a medication used to treat type 2 diabetes, not type 1 diabetes. It stimulates the pancreas to produce more insulin. Type 1 diabetes is characterized by a lack of insulin production, so taking glyburide would not be appropriate.

C) Administer glucagon for hyperglycemia:

Glucagon is a hormone used to raise blood sugar levels, typically in cases of severe hypoglycemia (low blood sugar). It is not used to treat hyperglycemia (high blood sugar) in type 1 diabetes. Instead, insulin administration is the primary method for managing high blood sugar levels.

D) Inject insulin in the deltoid muscle:

Insulin injections for individuals with type 1 diabetes are typically given in the subcutaneous fat, which is found just beneath the skin. The deltoid muscle is not a recommended site for insulin injections due to inconsistent absorption. The abdomen, thighs, and buttocks are commonly recommended injection sites.

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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?

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