What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness?
Give the child half his regular morning dose of insulin
Substitute simple carbohydrates or calorie-containing liquids for solid foods
Give the child plenty of unsweetened, clear liquids to prevent dehydration
Take the child directly to the emergency department
The Correct Answer is B
The child should receive his regular dose of insulin even if he does not have an appetite. If the child is not eating as usual, he needs calories to prevent hypoglycemia. During periods of minor illness, the child with type 1 diabetes mellitus can be managed safely at home.
Choice A is wrong because giving the child half his regular morning dose of insulin can lead to hyperglycemia and ketoacidosis.
Choice C is wrong because giving the child plenty of unsweetened, clear liquids to prevent dehydration can also cause hypoglycemia.
Choice D is wrong because taking the child directly to the emergency department is not necessary unless the child has signs of severe dehydration, vomiting, abdominal
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Correct Answer is D
Explanation
Ulcerative colitis is a chronic inflammatory bowel disease that causes diarrhea, pain, and bleeding in the colon. Stress and certain foods can trigger or worsen the symptoms, so it is important to teach the mother how to help her son cope with stress and avoid triggers.
Choice A is wrong because ulcerative colitis is not an infectious disease that can spread to others.
Choice B is wrong because ulcerative colitis causes diarrhea, not constipation. Nutritional guidance is important, but not the main focus of teaching.
Choice C is wrong because the daily use of enemas is not part of the treatment plan for ulcerative colitis. Enemas can irritate the colon and cause more inflammation.
Correct Answer is D
Explanation
choice D. Monitor blood glucose levels frequently and observe closely for signs of hypoglycemia. This is because a macrosomic infant (a newborn who’s much larger than average) is at risk of developing low blood sugar levels after birth, especially if the mother has diabetes. Hypoglycemia can cause neurological damage in the newborn, so it is important to detect and treat it promptly.
Choice A is wrong because leaving the infant in the room with the mother without monitoring the blood glucose levels may miss signs of hypoglycemia and delay treatment.
Choice B is wrong because taking the infant immediately to the nursery may separate the infant from the mother and interfere with breastfeeding, which can help prevent hypoglycemia.
Choice C is wrong because performing a gestational age assessment to determine whether the infant is large for gestational age is not urgent and does not address the risk of hypoglycemia.
Normal ranges for blood glucose levels in term infants are 2.6 mmol/L or higher at any time. A blood glucose level of 2.5 mmol/L or less is considered hypoglycemic.
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