A nurse is providing teaching to a school-age child who has a diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates a need for additional teaching?
"I should not take my regular insulin when I am sick."
"I will rotate injections sites within my abdominal area."
"I will test my blood sugar before meals and at bedtime."
"I should eat a snack before I play soccer."
The Correct Answer is A
A. "I should not take my regular insulin when I am sick." Regular insulin should not be withheld during illness, as blood glucose levels can increase during times of stress or infection. This statement indicates the child needs further education on managing diabetes during illness.
B. "I will rotate injections sites within my abdominal area." Rotating injection sites within a specific area helps to prevent lipodystrophy and ensures consistent absorption of insulin. This statement shows appropriate understanding.
C. "I will test my blood sugar before meals and at bedtime." Frequent monitoring of blood glucose is essential in managing type 1 diabetes. This statement indicates correct knowledge of monitoring practices.
D. "I should eat a snack before I play soccer." Eating a snack before physical activity helps to prevent hypoglycemia. This statement indicates a proper understanding of diabetes management related to exercise.
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Correct Answer is C
Explanation
A. Take the prescribed insulin 30 minutes before practice or game time rather than in the morning. Insulin timing should generally be consistent with meal times to match insulin action with food intake. Adjusting timing without medical advice can lead to imbalanced blood sugar levels.
B. Eat half the amount of food normally eaten at lunchtime. Eating less food than usual can lead to hypoglycemia during prolonged physical activity and is not recommended.
C. Eat six graham crackers or drink a cup of orange juice before practice or game time. This action helps to prevent hypoglycemia during physical activity by providing quick-acting carbohydrates that can be readily absorbed and utilized by the body.
D. Take two times the amount of prescribed insulin on practice and game days. Doubling insulin doses without medical supervision can lead to hypoglycemia and is not appropriate for managing blood sugar during physical activity.
Correct Answer is D
Explanation
A. "I will report changes in breathing or signs of confusion." Correct action as changes in breathing or confusion can indicate diabetic ketoacidosis or other serious complications.
B. "I will encourage him to drink a half a cup of water or sugar-free fluid every 30 minutes."Ensuring adequate fluid intake helps prevent dehydration and helps manage blood sugar levels during illness.
C. "I will notify the doctor if his temperature is not controlled with acetaminophen." Correct action as fever may indicate an infection that needs further medical evaluation and treatment.
D. "I will continue to check his blood sugar two times every day." When a child with diabetes is ill, blood sugar should be monitored more frequently, typically every 3-4 hours, to manage the risk of hyperglycemia or hypoglycemia due to illness.
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