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) Smokey brown urine:

This finding is not typically associated with nephrotic syndrome. Smokey brown urine might indicate the presence of blood in the urine, which can be seen in conditions such as hematuria or certain kidney infections.

B) Polyuria:

Polyuria refers to excessive urination and is not a primary characteristic of nephrotic syndrome. However, children with nephrotic syndrome may have decreased urine output due to the loss of fluid and proteins through the damaged kidney filters.

C) Facial edema:

Facial edema (swelling of the face) is a hallmark of nephrotic syndrome. The loss of albumin in the urine results in a decrease in oncotic pressure (a force that helps keep fluid in the blood vessels), leading to fluid accumulation in the interstitial spaces, including the face, ankles, and abdomen.

D) Hypertension:

Hypertension (high blood pressure) is not a typical finding of nephrotic syndrome itself. However, it's possible for kidney damage to lead to secondary hypertension. In nephrotic syndrome, low levels of albumin can trigger the renin-angiotensin-aldosterone system, which can contribute to increased blood pressure.

A. Pallor:

Pallor refers to paleness of the skin. While it can be associated with various medical conditions, it is not a typical symptom of hyperglycemia. Pallor is more commonly seen in conditions related to anemia or circulatory issues.

B. Lethargy

Explanation:

A blood glucose level of 280 mg/dL in a school-age child indicates hyperglycemia, which is an abnormally high level of glucose in the blood. Hyperglycemia commonly occurs in diabetes mellitus, specifically in Type 1 or Type 2 diabetes. Lethargy is a symptom associated with high blood glucose levels. It is characterized by a state of extreme tiredness, sluggishness, and reduced responsiveness. Hyperglycemia can lead to an inadequate supply of glucose to the brain cells, which can result in lethargy and confusion.

C. Shallow respirations:

Shallow respirations typically do not directly correlate with high blood glucose levels. Hyperglycemia's primary symptoms are related to changes in metabolism and glucose utilization, and it doesn't usually affect respiratory patterns in the same way that, for instance, respiratory distress might occur with conditions like ketoacidosis in diabetes.

D. Tremors:

Tremors, or uncontrollable shaking or trembling, are more commonly associated with hypoglycemia (low blood glucose levels) rather than hyperglycemia. Low blood glucose levels can cause the body to release adrenaline, leading to symptoms like tremors, anxiety, and sweating.