The nurse is instructing the parent of a 10-year-old child newly diagnosed with type 1 diabetes mellitus (DM) on how to administer subcutaneous insulin injections.

The parent expresses a fear of needles and is unable to perform the procedure.

What intervention should the nurse implement?

Choice A rationale
If the child is sleeping now and is difficult to wake, this could be a sign of worsening respiratory status. Children with respiratory distress often have difficulty sleeping due to discomfort and difficulty breathing. If the child is now sleeping and difficult to wake, this could indicate a decrease in oxygen levels, leading to lethargy and decreased responsiveness. This would require immediate attention.
Choice B rationale
The vital signs provided indicate a potentially serious situation. A heart rate of 130 beats/minute is high for a 3-year-old child, indicating that the heart is working harder to pump blood. A respiratory rate of 15 breaths/minute is on the lower end of normal for a 3-year-old, which could indicate that the child is not getting enough oxygen. An oxygen saturation of 66% on a 5L face mask is dangerously low, indicating severe hypoxia. A temperature of 102.8° F(39.3° C) axillary indicates a fever, which could be a sign of infection. A blood pressure of 92/48 mm Hg is within normal range for a 3-year-old.
Choice C rationale
If the child is active and playing with toys, this could indicate that his respiratory status is not worsening. Children who are experiencing respiratory distress often have difficulty engaging in normal activities due to discomfort and shortness of breath. If the child is able to play normally, this could indicate that he is getting enough oxygen and his condition is stable.
Choice D rationale
If the child’s breathing has returned to normal, this could indicate that his respiratory status is improving. However, it’s important to continue monitoring the child closely, as respiratory conditions can change rapidly, especially in young children.

Choice A rationale
Both mother and daughter shedding tears of joy and gratitude may not necessarily indicate a healthy psychosocial adaptation. While it could be a sign of relief or happiness, it could also be a response to stress or fear.
Choice B rationale
The mother expressing her full support for her daughter can be a positive sign of psychosocial adaptation. Support from family members can play a crucial role in coping with and adapting to health-related challenges.
Choice C rationale
The mother appearing sad does not necessarily indicate a healthy psychosocial adaptation. It could be a normal reaction to her daughter’s discomfort, but it could also suggest that she is struggling to cope with the situation.
Choice D rationale
The patient giving birth to a healthy baby boy is not relevant to the question as it does not provide information about the psychosocial adaptation of the mother or the daughter.
Choice E rationale
The mother commending her daughter can be a positive sign of psychosocial adaptation. Positive reinforcement can help individuals cope with challenging situations and foster a sense of self-efficacy.
Choice F rationale
Both mother and daughter gently touching the baby’s cheek is not relevant to the question as it does not provide information about the psychosocial adaptation of the mother or the daughter.