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?
“I will continue to check his blood sugar two times every day.”
"I will report a change in her breathing or any signs of confusion.”
“I will encourage her to drink half a cup of water or sugar-free fluid every 30 minutes”
"I will notify the doctor if her temperature is not controlled by acetaminophen”
The Correct Answer is A
A. "I will continue to check his blood sugar two times every day."
Correct Explanation: This statement indicates a need for further instruction.
Explanation: A child with type 1 diabetes requires frequent blood sugar monitoring, especially during illness. Checking blood sugar only twice a day is not sufficient, especially when the child has an upper respiratory infection. Illness can impact blood sugar levels, so more frequent monitoring is necessary to ensure proper diabetes management.
B. "I will report a change in her breathing or any signs of confusion."
Incorrect Explanation: This statement shows awareness of potential complications and the need to monitor for them.
Explanation: Children with type 1 diabetes are at risk of diabetic ketoacidosis (DKA) when they are sick. Changes in breathing patterns and signs of confusion are symptoms of DKA. Reporting these symptoms is important, as it could indicate a serious diabetic complication.
C. "I will encourage her to drink half a cup of water or sugar-free fluid every 30 minutes."
Incorrect Explanation: This statement demonstrates proper fluid management, especially during illness.
Explanation: Encouraging the child to stay hydrated with sugar-free fluids is essential, particularly when the child has an upper respiratory infection. Proper hydration helps prevent dehydration, which can be more concerning for a child with diabetes.
D. "I will notify the doctor if her temperature is not controlled by acetaminophen."
Incorrect Explanation: This statement shows an understanding of the importance of managing fever in a child with diabetes.
Explanation: Children with diabetes can experience difficulty managing blood sugar levels when they're sick. Fever can exacerbate this issue. Using acetaminophen to control fever is appropriate, and notifying the doctor if fever persists is a responsible action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
A. The fact that the patient is male
Incorrect Explanation: The patient's gender does not directly provide important information about the history of reflux.
Explanation: Vesicoureteral reflux (VUR), which is the retrograde flow of urine from the bladder into the ureters, can affect individuals of any gender. While gender might have some implications for certain conditions, it is not a critical factor in understanding the history of reflux.
B. The fact that the patient is female.
Incorrect Explanation: The patient's gender does not directly provide important information about the history of reflux.
Explanation: Just like with the previous option, the patient's gender does not play a significant role in the history of vesicoureteral reflux. The condition can affect both males and females.
C. Developmental milestones
Correct Explanation: Developmental milestones are important in understanding the history of reflux.
Explanation: Developmental milestones are significant because VUR is more common in infants and young children. Infants and young children have a higher likelihood of developing reflux due to the immaturity of their urinary tract systems. Knowing about the patient's developmental milestones can help assess the risk and potential severity of reflux.
D. The number of urinary tract infections the patient has had
Correct Explanation: The number of urinary tract infections (UTIs) is important in understanding the history of reflux.
Explanation: Repeated urinary tract infections can be a sign of vesicoureteral reflux. The backflow of urine from the bladder into the ureters can contribute to UTIs. Monitoring the frequency of UTIs can provide insights into the presence and severity of reflux.
Correct Answer is C
Explanation
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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