A nurse is caring for a child in the PACU following a tonsillectomy. Which of the following findings requires immediate intervention by the nurse?

A. Nightmares are common in children and may not be directly related to the brain tumor. While they should be addressed, they are not the priority in this case.

B. Hyperactivity can be a normal behavior in preschoolers. It may or may not be related to the brain tumor. Other symptoms should take precedence.

C. Pruritus (itching) is a common symptom that can have various causes, and it may not be directly related to the brain tumor. It should be addressed but is not the priority in this case.

D. Correct. Diplopia (double vision) can be a neurological symptom associated with increased

intracranial pressure or other complications related to a brain tumor. It is important to report this finding promptly to the provider for further evaluation and intervention.

A.While an elevated cholesterol level is a concern in diabetes, it is not the priority in this case. The elevated HbA1c level indicates a more pressing issue that requires immediate attention.

B. The correct answer is B. HbA1c 11.5%. HbA1c is a measure of the average blood glucose level over the past 2 to 3 months. A high HbA1c indicates poor glycemic control and increased risk of complications from diabetes. The nurse's priority is to address the factors that are contributing to the high HbA1c and provide education and support to improve the adolescent's self-management.

C. Glycosuria, while important to monitor, is a common finding in uncontrolled diabetes.
It indicates elevated blood glucose levels and may require adjustments in the treatment plan. However, it is not as critical as addressing the elevated HbA1c level.

D. A preprandial blood glucose level of 124 mg/dL is within a reasonable range for an adolescent with diabetes. It is important to monitor blood glucose levels, but the elevated HbA1c level takes precedence in this situation.