A nurse is providing discharge teaching to the parents of a child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parents indicates an understanding of the teaching?

A) Heat intolerance.

Explanation: This statement is true. Heat intolerance is a common symptom of hyperthyroidism, including Graves' disease. People with hyperthyroidism often have an overactive thyroid gland that produces an excessive amount of thyroid hormones. This can lead to an increased metabolic rate, which in turn makes them sensitive to heat. They may feel excessively warm, sweat more than usual, and have difficulty tolerating hot weather.

B) Weight gain.

Explanation: This statement is false. Weight gain is not a typical finding in Graves' disease or hyperthyroidism. In fact, one of the hallmark symptoms of hyperthyroidism is unexplained weight loss despite increased appetite. The elevated levels of thyroid hormones cause an increase in metabolism, leading to weight loss.

C) Bradycardia.

Explanation: This statement is false. Bradycardia refers to an abnormally slow heart rate, typically below 60 beats per minute. In hyperthyroidism, the heart rate is often elevated rather than slowed down. The excessive thyroid hormones can lead to an increased heart rate (tachycardia) and palpitations. It's important to note that if the question were about hypothyroidism (underactive thyroid), bradycardia might be more relevant.

D) Lethargy.

Explanation: This statement is false. Lethargy, or a state of extreme tiredness and lack of energy, is more commonly associated with hypothyroidism (underactive thyroid) rather than hyperthyroidism. Hyperthyroidism usually leads to symptoms of increased energy, restlessness, and hyperactivity due to the elevated metabolic rate caused by excess thyroid hormones.

Digoxin is a medication commonly used to treat certain heart conditions, including some congenital heart defects. It's important to monitor the heart rate and other signs of toxicity when administering digoxin, especially in pediatric patients. Let's break down the information given:

The pediatric maintenance dose of digoxin is 5 mcg/kg daily.

The child weighs 55 pounds (approximately 25 kg).

Given these values, the total daily dose for this child would be:

Total daily dose = 5 mcg/kg × 25 kg = 125 mcg

This total daily dose is usually given as a single dose. However, the child's heart rate is noted to be only 50 beats per minute (bpm). A heart rate of 50 bpm in a child could potentially indicate bradycardia (slow heart rate), which can be a sign of digoxin toxicity. Bradycardia is a known adverse effect of digoxin, and it's important to assess for other signs of toxicity as well, such as nausea, vomiting, and changes in color vision.

In this case, it would be prudent to withhold the digoxin and assess the child further for signs of toxicity or bradycardia. The dose should not be administered until the healthcare provider is consulted and appropriate action is determined.

So, the correct answer is indeed NO. Administering the digoxin without considering the slow heart rate and the potential for toxicity could be unsafe for the child.