A nurse is teaching a school-age child who has type 1 diabetes mellitus and his parents about illness management. Which of the following instructions should the nurse include?
"Limit fluid intake during meal time."
"Notify the provider if blood glucose levels are over 350 milligrams/decilitre
Test the urine for ketones.
"Withhold insulin dose if feeling nauseous"
The Correct Answer is C
A) "Limit fluid intake during mealtime":
Limiting fluid intake during meals is not a standard practice for managing type 1 diabetes. Proper hydration is important for overall health, and fluids should be consumed as needed.
B) "Notify the provider if blood glucose levels are over 350 milligrams/deciliter":
Blood glucose levels over 350 mg/dL can indicate hyperglycemia, which requires prompt attention. High blood glucose levels can lead to complications if not addressed promptly. Contacting the healthcare provider is an appropriate step. However, consistent Blood Glucose Levels Above 240 mg/dL (13.3 mmol/L) or presence of symptoms like frequent urination, thirst, blurry vision, or fatigue) are concerning. The client should have contacted the health care provider by this point.
C) "Test the urine for ketones":
Testing urine for ketones is an important instruction. Ketones are produced when the body breaks down fat for energy, often in the absence of sufficient insulin. High ketone levels can indicate diabetic ketoacidosis (DKA), a serious complication. Regular ketone testing, especially during illness or high blood glucose levels, helps monitor for DKA.
D) "Withhold insulin dose if feeling nauseous":
This instruction is not accurate. Nausea could be a sign of various conditions, including illness. Insulin should not be withheld without consulting a healthcare provider. Managing insulin doses appropriately is crucial to maintaining blood glucose control
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Related Questions
Correct Answer is A
Explanation
Fluid Requirement (mL/24 hours) = Weight (kg) × Fluid Requirement (mL/kg)
Given that the child weighs 70.4 pounds, we first need to convert this weight to kilograms (1 lb = 0.453592 kg):
Weight in kg = 70.4 lb × 0.453592 kg/lb ≈ 31.89 kg
Now, let's calculate the fluid requirement using the given choices:
A) 1740:
Fluid Requirement = 31.89 kg × 55 mL/kg = 1753.95 mL
B) 134056:
This number is significantly larger than any reasonable fluid requirement and is likely an error.
C) 2:
This value is far too low to represent the fluid requirements of a child.
D) 12:
This value is also too low to represent the fluid requirements of a child.
So, the correct answer is A) 1740 mL. The child's estimated daily fluid requirement would be around 1740 mL in a 24-hour period, based on a weight of 70.4 pounds.
Correct Answer is D
Explanation
a. Allow for adjustment of rules to correlate with the child's behavior: While flexibility can be important, allowing rules to be adjusted based on behavior can lead to inconsistency and confusion for the child. Consistent rules and expectations are crucial for children with ASD, as they thrive on predictability and structure.
b. Allow for imaginative play with peers without supervision: Children with ASD may have difficulties with social interactions and imaginative play. Supervision is important to ensure that play is safe, appropriate, and supportive of social skill development. Unsupervised play might not be beneficial if it leads to misunderstandings or conflicts.
c. Provide a flexible schedule that adjusts to the child's interests: Children with ASD generally benefit from a structured and predictable schedule rather than a flexible one that changes based on their interests. Predictability helps them feel secure and reduces anxiety. A flexible schedule could lead to increased stress and difficulty in transitioning between activities.
d. Establish a reward system for positive behavior: A reward system is an effective strategy for encouraging positive behavior in children with ASD. Reinforcement of desired behaviors helps to build and maintain new skills and can provide motivation. This approach aligns well with behavioral interventions commonly used with children on the autism spectrum.
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