The nurse is caring for an infant who weighs 16 kg. Calculate the daily maintenance fluid requirement for this child. Round to the nearest whole number.

Choice A reason: Weight loss is a common clinical manifestation of type 1 diabetes mellitus in children. Type 1 diabetes mellitus is a condition where the pancreas does not produce enough insulin, a hormone that helps the cells use glucose for energy. Without insulin, the glucose stays in the blood and causes high blood sugar levels. The body then breaks down fat and muscle for energy, resulting in weight loss.

Choice B reason: Low urine output is not a typical clinical manifestation of type 1 diabetes mellitus in children. In fact, the opposite is true: high urine output is a sign of type 1 diabetes mellitus. This is because the excess glucose in the blood draws water from the cells and tissues, causing dehydration and increased thirst. The kidneys then try to flush out the glucose and water through urine, leading to frequent urination.

Choice C reason: Weight gain is not a usual clinical manifestation of type 1 diabetes mellitus in children. As explained in choice A, type 1 diabetes mellitus causes weight loss due to the lack of insulin and the breakdown of fat and muscle. Weight gain can be a sign of type 2 diabetes mellitus, which is a condition where the cells become resistant to insulin and the pancreas cannot produce enough insulin to overcome the resistance. Weight gain can also be a side effect of insulin therapy, which is used to treat both types of diabetes mellitus.

Choice D reason: Hand tremors are not a specific clinical manifestation of type 1 diabetes mellitus in children. Hand tremors can be caused by many factors, such as anxiety, stress, caffeine, medication, or neurological disorders. Hand tremors can also be a symptom of hypoglycemia, which is a condition of low blood sugar that can occur in people with diabetes mellitus. However, hypoglycemia is not exclusive to diabetes mellitus, and can affect anyone who has a low intake of food, a high expenditure of energy, or a high dose of insulin or oral hypoglycemic agents.

Choice A reason: Foot inspection is not an annual/yearly screening, but a daily self-care practice for people with diabetes. Foot inspection involves checking the feet for any signs of injury, infection, or ulceration, such as cuts, blisters, redness, swelling, or drainage. Foot inspection can help prevent or detect foot problems, such as neuropathy, ischemia, or infection, which can lead to amputation if left untreated. The nurse should teach Jo how to inspect his feet every day, and how to care for his feet, such as washing, drying, moisturizing, trimming nails, and wearing proper footwear.

Choice B reason: Serum creatinine (Cr) is an annual/yearly screening for people with diabetes. Serum creatinine is a blood test that measures the level of creatinine, a waste product that is filtered by the kidneys. Serum creatinine can indicate the kidney function, and detect kidney damage or disease, which is a common complication of diabetes. The nurse should explain to Jo that he needs to have his serum creatinine checked every year, and that he should keep his blood glucose and blood pressure under control, as these are the main risk factors for kidney problems.

Choice C reason: Chest X-ray is not an annual/yearly screening for people with diabetes, unless they have symptoms or risk factors for lung diseases, such as tuberculosis, pneumonia, or cancer. Chest X-ray is an imaging test that uses X-rays to produce pictures of the lungs and the chest cavity. Chest X-ray can help diagnose or monitor lung conditions, such as infections, inflammations, or tumors. The nurse should ask Jo about his history of smoking, exposure to environmental pollutants, or respiratory symptoms, such as cough, shortness of breath, or chest pain, and refer him to a doctor if he needs a chest X-ray.

Choice D reason: White blood cell count (WBC) is not an annual/yearly screening for people with diabetes, unless they have signs or risk factors for infections, such as fever, wounds, or immunosuppression. White blood cell count is a blood test that measures the number and types of white blood cells, which are the cells that fight infections and inflammation. White blood cell count can help diagnose or monitor infections, such as bacterial, viral, or fungal infections, or immune disorders, such as allergies, autoimmune diseases, or cancers. The nurse should assess Jo for any signs of infection, such as fever, chills, malaise, or pus, and advise him to seek medical attention if he has any.