The nurse is caring for a 4-month-old infant in the emergency department. The nurse reviews the infant's medical record and assessment findings. Which of the following conditions should the nurse suspect, and what actions should the nurse take to address that condition, and what parameters should the nurse monitor to assess the infant's progress?

The nurse should suspect that the infant has

Choice A reason: Glyburide is an oral medication that lowers blood sugar by stimulating the pancreas to produce more insulin. It is not used for type 1 diabetes mellitus, as the pancreas cannot produce enough insulin in this condition. Glyburide is used for type 2 diabetes mellitus, which is caused by insulin resistance.

Choice B reason: Obtaining an influenza vaccine annually is recommended for people who have type 1 diabetes mellitus, as they are more prone to complications from the flu, such as pneumonia, ketoacidosis, and hospitalization. The vaccine can help prevent or reduce the severity of the flu and its complications.

Choice C reason: Injecting insulin in the deltoid muscle is not the best practice for administering insulin, as the absorption rate and onset of action may vary depending on the muscle mass and blood flow. The preferred sites for insulin injection are the abdomen, the upper arms, the thighs, and the buttocks, as they have more subcutaneous fat and less muscle tissue. The injection site should also be rotated to prevent lipodystrophy.

Choice D reason: Administering glucagon for hyperglycemia is not appropriate, as glucagon is a hormone that raises blood sugar by stimulating the liver to release glucose. It is used for hypoglycemia, or low blood sugar, which is a common and serious complication of type 1 diabetes mellitus. Hyperglycemia, or high blood sugar, is treated with insulin, fluids, and electrolytes.

Choice A reason: Hypovolemia is a condition of low blood volume due to fluid loss from the burn injury. It can cause decreased urine output, hypotension, tachycardia, and poor skin turgor. The nurse should monitor the client's vital signs, fluid intake and output, and weight. The nurse should administer lactated Ringer's solution to maintain urine output of 30 ml/hr.

Choice B reason: Hyperkalemia is a condition of high potassium levels in the blood due to cellular damage from the burn injury. It can cause peaked T waves, dysrhythmias, muscle weakness, and cardiac arrest. The nurse should monitor the client's serum potassium levels, electrocardiogram, and cardiac status. The nurse should avoid administering potassium-containing fluids or medications.

Choice C reason: Hypocalcemia is a condition of low calcium levels in the blood due to fluid shifts from the burn injury. It can cause positive Chvostek's sign, tetany, seizures, and hypotension. The nurse should monitor the client's serum calcium levels, neurological status, and blood pressure. The nurse should administer calcium supplements as prescribed.

Choice D reason: Hypernatremia is a condition of high sodium levels in the blood due to fluid loss from the burn injury. It can cause dry mucous membranes, thirst, agitation, and seizures. The nurse should monitor the client's serum sodium levels, hydration status, and mental status. The nurse should administer hypotonic fluids as prescribed.