A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?

"The insulin can be injected anywhere there is adipose tissue."

"I will be sure my child rotates sites after 5 injections in one area."

"I will be sure my child aspirates before injecting the insulin."

"The insulin should be injected at a 90-degree angle."

Answer and Explanation

The Correct Answer is C

Choice A: This statement does not indicate a need for further teaching, as it is correct that insulin can be injected anywhere there is adipose tissue. Adipose tissue is the layer of fat under the skin that can absorb insulin and prevent damage to muscles or organs. The common sites for insulin injection are the abdomen, thighs, buttocks, or upper arms.

Choice B: This statement does not indicate a need for further teaching, as it is correct that the child should rotate sites after 5 injections in one area. Rotating sites can prevent lipodystrophy, which is a condition that causes abnormal changes in fat tissue due to repeated injections. Lipodystrophy can affect the appearance and absorption of insulin in the aﬀected area.

Choice C: This statement indicates a need for further teaching, as it is incorrect that the child should aspirate before injecting the insulin. Aspiration is the process of pulling back on the plunger of the syringe to check for blood before injecting the medication. Aspiration is not recommended for insulin injection, as it can cause pain, bruising, or leakage of insulin from the injection site.

Choice D: This statement does not indicate a need for further teaching, as it is correct that insulin should be injected at a 90-degree angle. Injecting insulin at a 90-degree angle can ensure that the medication reaches the adipose tissue and prevents skin irritation or muscle damage. The only exception is if the child has very thin skin or uses very short needles, in which case they may inject at a 45-degree angle.

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Correct Answer is A

Explanation

Choice A: Encouraging the parents to rock the infant is an appropriate action for a nurse to take, as it can provide comfort, security, and bonding for the infant who is recovering from surgery. Rocking can also soothe the infant's pain and distress and promote sleep and relaxation.

Choice B: Administering blood thinners as needed for pain is not an appropriate action for a nurse to take, as blood thinners are not analgesics and can cause bleeding complications in an infant who is postoperative. Blood thinners are medications that prevent or reduce blood clotting, which can increase the risk of hemorrhage or hematoma. The nurse should administer analgesics, such as acetaminophen or ibuprofen, as prescribed by the provider for pain relief.

Choice C: Positioning the infant on her abdomen is not an appropriate action for a nurse to take, as it can cause pressure or trauma to the surgical site and increase the risk of infection or dehiscence. Positioning the infant on her abdomen can also impair the infant's breathing and oxygenation and increase the risk of sudden infant death syndrome (SIDS). The nurse should position the infant on her back or side with her head elevated and supported.

Choice D: Oﬀering the infant a pacifier is not an appropriate action for a nurse to take, as it can cause suction or friction on the surgical site and increase the risk of infection or dehiscence. Oﬀering the infant a pacifier can also interfere with the infant's feeding and nutrition and cause nipple confusion or preference. The nurse should avoid giving the infant anything in her mouth except for a bottle or breast with a special nipple that does not touch the surgical site.

A. Improve the client's school attendance skills. B. Provide teaching on self-care activities. C. Modify the environment for optimal safety and mobility. D. Provide counseling services for the parents.

Correct Answer is C

Explanation

Choice A: Improving the client's school attendance skills is not the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Improving the client's school attendance skills is a long-term goal that requires collaboration with the school staff, the child, and the parents. The priority goal for a child who has hemiplegic cerebral palsy is to ensure their safety and mobility at home.

Choice B: Providing teaching on self-care activities is not the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Providing teaching on self-care activities is an important goal that requires assessment of the child's abilities, needs, and preferences. The priority goal for a child who has hemiplegic cerebral palsy is to ensure their safety and mobility at home.

Choice C: Modifying the environment for optimal safety and mobility is the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Modifying the environment for optimal safety and mobility can prevent falls, injuries, or complications and promote independence and function. The nurse should include interventions such as removing clutter, securing rugs, installing grab bars, providing adaptive equipment, and arranging furniture.

Choice D: Providing counseling services for the parents is not the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Providing counseling services for the parents is a supportive goal that requires referral to appropriate resources, such as social workers, psychologists, or support groups. The priority goal for a child who has hemiplegic cerebral palsy is to ensure their safety and mobility at home.

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A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?

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