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

"I will report changes in breathing or signs of confusion."

"I will encourage him to drink a half a cup of water or sugar-free fluid every 30 minutes."

"I will notify the doctor if his temperature is not controlled with acetaminophen."

"I will continue to check his blood sugar two times every day."

Answer and Explanation

The Correct Answer is D

A. "I will report changes in breathing or signs of confusion." Correct action as changes in breathing or confusion can indicate diabetic ketoacidosis or other serious complications.
B. "I will encourage him to drink a half a cup of water or sugar-free fluid every 30 minutes."Ensuring adequate fluid intake helps prevent dehydration and helps manage blood sugar levels during illness.
C. "I will notify the doctor if his temperature is not controlled with acetaminophen." Correct action as fever may indicate an infection that needs further medical evaluation and treatment.
D. "I will continue to check his blood sugar two times every day." When a child with diabetes is ill, blood sugar should be monitored more frequently, typically every 3-4 hours, to manage the risk of hyperglycemia or hypoglycemia due to illness.

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Correct Answer is D

Explanation

A. Apply cold compresses to the affected areas. Cold can cause vasoconstriction, which may worsen the sickling and pain. Heat packs are generally recommended to promote circulation and relieve pain.
B. Implement pain management on a PRN basis. Pain management should be consistent and proactive rather than PRN (as needed). Regular pain control is essential in managing sickle cell crises.
C. Active range-of-motion (ROM) exercises daily. During a crisis, the child should rest and avoid physical activity to prevent further pain and complications. ROM exercises are more appropriate during non-crisis times for maintaining joint function.
D. Promote hydration with IV and oral fluids. Hydration is crucial during a sickle cell crisis as it helps to decrease blood viscosity, reducing the risk of further sickling and vaso-occlusive events.

A. Dilute the medication with 240 mL (8 oz) of milk. B. Administer the medication at meal time. C. Administer the medication at bedtime. D. Offer the medication through a straw.

Correct Answer is B

Explanation

A. Dilute the medication with 240 mL (8 oz) of milk. Milk can inhibit iron absorption, so it's not recommended to mix iron supplements with milk.
B. Administer the medication at meal time. Iron supplements are best absorbed when taken with food, specifically vitamin C-rich foods to enhance absorption. This instruction promotes optimal therapeutic effect.
C. Administer the medication at bedtime: Timing with meals is more effective than at bedtime.
D. Offer the medication through a straw. The method of administration is less critical than the timing with meals.

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

Nursing Test Bank

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