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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Correct answer: D
A.This can be a good distraction technique, but it might not directly facilitate the lung sound assessment.
B.This activity might help engage the child but could make it difficult for the nurse to listen to breath sounds accurately.
C.Holding a toy might keep the child occupied but does not directly relate to the assessment process and might not ensure cooperation as effectively as using a stethoscope on a stuffed animal.
D.Allowing the child to use the stethoscope on a stuffed animal can help reduce fear and anxiety by making the procedure more familiar and less intimidating. It engages the child in a playful and interactive manner, helping to build trust and cooperation.
Correct Answer is C
Explanation
A. Weight loss can occur in acute glomerulonephritis due to decreased appetite and fluid imbalances, but it is not as immediately concerning as low blood pressure.
B. A positive rapid strep test of the oropharynx suggests streptococcal infection, which can be a cause of acute glomerulonephritis. It's important to report this finding to the healthcare provider, but the low blood pressure is of more immediate concern.
C. Blood pressure 88/50 mm Hg.
Acute glomerulonephritis can lead to various signs and symptoms, including fatigue, facial puffiness, decreased appetite, and dark urine, due to the presence of blood and protein in the urine. However, the drop in blood pressure (88/50 mm Hg) is a significant finding that may suggest potential complications or worsening renal function. Low blood pressure can result from fluid shifts, reduced circulating blood volume, and decreased cardiac output in acute glomerulonephritis. It should be reported to the healthcare provider for further evaluation and management.
D. A maculopapular rash over the trunk of the body is not a typical finding associated with acute glomerulonephritis. While it may be significant for other reasons, it may not be directly related to the child's kidney condition.
Monitoring and addressing blood pressure changes is a crucial aspect of managing acute glomerulonephritis, and the healthcare provider should be informed promptly to assess and address this issue.
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