A nurse is caring for a 7-year-old child who has an upper respiratory infection and type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instruction?

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.

A. "We worry about surgery. Do you think we should investigate direct donation of blood?"

Explanation: This statement doesn't show a clear understanding of nephrotic syndrome. Nephrotic syndrome is a kidney disorder that involves the kidneys' ability to filter blood, but it doesn't typically involve blood donation or surgery related to that. Direct donation of blood is not relevant to the treatment or management of nephrotic syndrome.

B. "We'll have to encourage lots of liquids. Did you say about Biters per day?"

Explanation: This statement suggests a misunderstanding of nephrotic syndrome and its management. Encouraging lots of liquids is generally not a primary concern in nephrotic syndrome. In fact, excess fluid intake might be counterproductive, as it could worsen edema (swelling) that often occurs with this condition. Additionally, the term "Biters per day" doesn't seem relevant to nephrotic syndrome or its management.

C. "My child really likes chips and bologna. I guess we will have to find something else."

Explanation: This statement indicates an understanding of dietary considerations related to nephrotic syndrome. Nephrotic syndrome involves protein loss through the urine, which can lead to low protein levels in the blood. To address this, dietary changes are often recommended to include foods rich in protein. Avoiding high-sodium foods like chips and bologna is also important, as excessive sodium intake can contribute to fluid retention and worsen edema.

D. "We understand the need for antibiotics, hope they can be given orally."

Explanation: This statement doesn't relate to nephrotic syndrome or its management. Nephrotic syndrome primarily involves issues with kidney function and protein loss, and antibiotics are not a standard treatment for this condition. Antibiotics are used to treat infections, which can sometimes be a complication of nephrotic syndrome due to the immune system's vulnerability, but the statement doesn't focus on the understanding of the disease itself.

Correct Answer: C. "My child really likes chips and bologna. I guess we will have to find something else."

Explanation: This statement shows an understanding of the dietary changes needed for a child with nephrotic syndrome. It acknowledges the importance of adjusting the child's diet to include protein-rich foods and avoid high-sodium options, which aligns with the nutritional considerations for managing nephrotic syndrome.