The nurse is giving instructions to the mother of a 10-year-old boy who is newly diagnosed with type 1 diabetes mellitus (DM). When attempting to teach the mother how to administer subcutaneous insulin injections to the child, the mother tells the nurse that she is afraid of needles and cannot perform the procedure.
Which intervention should the nurse implement?

Choice A rationale

Gathering supplies for an IV infusion is essential in many cases but not the priority here. Measuring abdominal circumference helps determine if there is abdominal distention indicating a possible blockage, which could suggest a condition like Hirschsprung's disease. Early detection and appropriate intervention are critical, making it the first action.

Choice B rationale

Preparing for anorectal surgery may be necessary if a diagnosis like Hirschsprung’s disease or imperforate anus is confirmed. However, the initial priority is to assess for signs of abdominal distention by measuring the circumference, providing crucial information for the next steps.

Choice D rationale

Monitoring strict urinary output is important for overall fluid balance and identifying complications related to fluid shifts. However, in this scenario, the priority action is to assess for abdominal distention, a potential sign of a serious underlying condition causing the symptoms observed in the infant.

Choice A rationale

Encouraging the child to dress in clothing that suits her sexual maturity level is not an appropriate approach for managing precocious puberty. The goal of treatment with LHRH is to delay further development until the appropriate age, allowing the child to dress according to her chronological age rather than her advanced physical maturity.

Choice B rationale

The purpose of LHRH therapy is to regulate and normalize the child's hormonal levels, which can slow or stop the progression of precocious puberty. As the therapy takes effect, differences in sexual maturity between the child and her peers should diminish over time, allowing her development to align more closely with her age group.

Choice C rationale

LHRH treatment for precocious puberty is typically not lifelong. It is used to delay puberty until a more appropriate age. Once treatment is stopped, the child's body will resume normal pubertal development. Parents should understand that the therapy is temporary and aimed at managing early onset puberty.

Choice D rationale

Starting the child on birth control pills is not a standard treatment for precocious puberty. The goal of LHRH therapy is to manage hormonal levels to delay puberty, not to prevent pregnancy. Birth control pills are not necessary and do not address the underlying condition being treated with LHRH therapy. .