When managing sick days for a child with Type 1 diabetes mellitus, which of the following should be included in the teaching?
Limit water intake to prevent hyponatremia.
Check blood glucose every 8-12 hours.
Drink 8oz of apple or orange juice every hour.
Always give scheduled insulin even if the child has no appetite.
The Correct Answer is D
Choice A reason: Limiting water intake is not recommended as adequate hydration is important, especially when sick.
Choice B reason: Checking blood glucose every 8-12 hours is not frequent enough; it should be monitored more often during illness.
Choice C reason: Drinking juice every hour is not necessary and could lead to hyperglycemia if not balanced with insulin.
Choice D reason: This is the correct choice. It is crucial to continue administering insulin as prescribed to manage blood glucose levels, even if the child is not eating as much.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: IV fluid replacement in DKA is typically isotonic, not hypertonic, to avoid rapid changes in osmolality.
Choice B reason: This is correct. While the total body potassium is depleted in DKA, the initial lab values often show hyperkalemia (high potassium) due to the metabolic acidosis, which shifts potassium out of the cells. This can lead to serious cardiac dysrhythmias and even cardiac arrest, making continuous cardiac monitoring and potassium level assessment a top priority.
Choice C reason: Monitoring for hypertension is important, but the primary concern in DKA is managing the acidosis and hyperglycemia.
Choice D reason: This is incorrect. Treatment for DKA involves a continuous IV infusion of regular insulin at a low, steady rate, not high doses of NPH insulin. NPH insulin is an intermediate-acting insulin and is not suitable for the acute management of DKA.
Correct Answer is D
Explanation
Choice A reason: While peer group acceptance is important, it is not the primary concern in this situation.
Choice B reason: Developing a sense of industry is part of Erikson's stages of psychosocial development but is not the primary nursing concern here.
Choice C reason: Whether the child can manage their own insulin and finger sticks is important, but safety is the primary concern.
Choice D reason: This is the correct choice. Ensuring the child's safety is paramount, as the school needs to be aware of the child's condition in case of a diabetes-related emergency.
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