A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment is most important for the nurse to obtain?

Understanding of quality control process used to troubleshoot the pump.

Interpretation of fingerstick glucose levels that influence diet selections.

Knowledge of her glycosylated hemoglobin A1c levels for past year.

Ability to program the pump for basal insulin with mealtime boluses.

Answer and Explanation

The Correct Answer is D

A. Understanding the quality control process used to troubleshoot the pump is important, but it is a secondary assessment and educational component. The primary focus should be on the child's ability to operate the pump effectively.

B. Interpretation of fingerstick glucose levels is important for diabetes management, but it does not specifically address the use of an insulin pump.

C. Knowledge of glycosylated hemoglobin A1c levels is valuable for assessing long-term glycemic control but is not the primary assessment needed when considering the transition to an insulin pump.

D Ability to program the pump for basal insulin with mealtime boluses.

When a child with type 1 diabetes mellitus expresses an interest in using an insulin pump, the most important assessment is their ability to program and manage the pump effectively. The nurse should assess whether the child and their family have the knowledge and skills to use the pump, including setting basal insulin rates and delivering mealtime boluses. The successful use of an insulin pump requires a good understanding of its operation and the ability to make adjustments based on the child's specific needs and glucose levels.

The ability to manage the insulin pump effectively is essential to ensure safe and appropriate diabetes management, making it the most important assessment in this context.

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Correct Answer is C

Explanation

A. While it's essential to monitor the infant's weight gain and the type of formula taken daily, this information is important for tracking growth and nutrition but is not directly related to the use of liquid multivitamin with fluoride.

B. The newborn's gestational age assessment is typically relevant during the immediate postnatal period and may not be as crucial at 6 months of age.

C. The water source used with supplemental feedings is critical when considering the use of liquid multivitamin with fluoride. Fluoride is often recommended to prevent tooth decay, and it's essential to know the fluoride content in the water source to determine whether additional supplementation is needed. If the water source has adequate fluoride, the infant may not require a fluoride supplement.

D. While the infant's current hemoglobin and hematocrit levels are important for assessing anemia, this assessment is not directly related to the request for a prescription for liquid multivitamin with fluoride. In summary, assessing the water source used for supplemental feedings is crucial to determine the necessity of a fluoride supplement, which is the primary concern in this scenario.

A. Surgery should be done by one month to prevent bladder infections. B. Repair should be done before the child is potty-trained. C. The urethral repair should be done after sexual maturity. D. Delaying the repair until school age reduces castration fears.

Correct Answer is B

Explanation

A. Surgery should be done by one month to prevent bladder infections. This statement is not accurate. While early surgery is generally recommended, the one-month timeframe is not a strict rule. The primary reason for early correction is to improve the cosmetic appearance of the penis, but it is not primarily aimed at preventing bladder infections.

B. Repair should be done before the child is potty-trained.

Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis rather than at the tip. Surgical correction is typically recommended, and the timing of the surgery is an important consideration.

C. The urethral repair should be done after sexual maturity. This statement is incorrect. Delaying the repair until sexual maturity is not the standard approach. In fact, earlier surgical correction is often recommended to ensure proper urinary function and to avoid potential psychological and social issues in the child.

D. Delaying the repair until school age reduces castration fears. This statement is not supported by current medical practice. Delaying the repair until school age can lead to psychosocial issues, as children may become more self-aware of their condition and experience teasing or psychological distress.

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A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment is most important for the nurse to obtain?

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Correct Answer is C

Explanation

The parents of a newborn infant with hypospadias are concerned about when the surgical correction should occur. Which information should the nurse provide?

Correct Answer is B

Explanation

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