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: Iron deficiency anemia is a condition in which the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the blood. Toddlers who drink too much milk and eat too few solid foods may not get enough iron from their diet, as milk is a poor source of iron. Iron deficiency anemia can cause fatigue, weakness, pale skin, and increased susceptibility to infections.

Choice B: Diabetes mellitus is a condition in which the body does not produce enough insulin or use it properly, resulting in high blood glucose levels. Toddlers who drink too much milk and eat too few solid foods are not at increased risk for diabetes mellitus, as milk does not contain glucose and does not affect insulin secretion or action.

Choice C: Obesity is a condition in which the body has excess fat that can impair health and increase the risk of chronic diseases. Toddlers who drink too much milk and eat too few solid foods may be at risk for obesity, as milk is high in calories and fat and can displace other nutritious foods from their diet. However, obesity is not a disorder but a risk factor for other disorders.

Choice D: Rickets is a condition in which the bones become soft and weak due to a lack of vitamin D or calcium. Toddlers who drink too much milk and eat too few solid foods are not at risk for rickets, as milk is a good source of vitamin D and calcium and can prevent rickets.

A. Iron (Ferrous Sulfate) may turn stools tarry green. B. Administer at bedtime. C. Give with a 240 mL (8 oz) glass of milk. D. Administer at mealtimes.

Correct Answer is A

Explanation

Choice A: This instruction is correct, as iron supplements can cause a change in the color and consistency of stools, making them dark, green, or black. This is not a sign of bleeding or infection, but a normal side effect of iron therapy. The parents should be informed of this possibility and reassured that it is harmless.

Choice B: This instruction is incorrect, as iron supplements should not be administered at bedtime, but rather one hour before or two hours after meals. This is because iron absorption is reduced by food, especially dairy products, antacids, or calcium supplements. The parents should be instructed to give the medication on an empty stomach or with a small amount of food if it causes nausea.

Choice C: This instruction is incorrect, as iron supplements should not be given with milk, as milk contains calcium, which can interfere with iron absorption and reduce its eﬀectiveness. The parents should be instructed to avoid giving milk or other dairy products within two hours of the medication.

Choice D: This instruction is incorrect, as iron supplements should not be administered at mealtimes, but rather one hour before or two hours after meals. This is because iron absorption is reduced by food, especially dairy products, antacids, or calcium supplements. The parents should be instructed to give the medication on an empty stomach or with a small amount of food if it causes nausea.

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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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