A hospitalized child has varicella. The nurse arranges for which type of infection precautions?

Choice A reason: Hypoglycemia in diabetes has a rapid onset due to sudden drops in blood glucose (<70 mg/dL), triggering sympathetic responses like trembling. This statement is correct, as it reflects the acute nature of hypoglycemic episodes, requiring no clarification, as the parent understands the urgency of symptom recognition.

Choice B reason: Nausea and trembling are common hypoglycemia symptoms, resulting from autonomic activation and cerebral glucose deprivation. This statement is correct, as these signs indicate low blood glucose, prompting timely intervention like glucose administration. The parent’s understanding aligns with hypoglycemia pathophysiology, requiring no further clarification in diabetes education.

Choice C reason: Feeling hot is not typical of hypoglycemia, which causes diaphoresis and cool, clammy skin due to sympathetic activation. Instead, feeling cold or sweaty is common. This statement is incorrect, indicating a need for clarification to ensure the parent recognizes accurate hypoglycemia symptoms for timely intervention in diabetes management.

Choice D reason: Sweating is a hallmark of hypoglycemia, caused by catecholamine release in response to low blood glucose. This statement is correct, as diaphoresis signals an acute need for glucose to prevent complications like seizures. The parent’s understanding is accurate, requiring no clarification in diabetes discharge teaching.

Choice A reason: NPH insulin has an onset of 1-2 hours, peaking at 4-12 hours. At 0900, 2 hours post-administration, the effect is minimal, with low hypoglycemia risk. Peak action, when hypoglycemia is most likely due to maximum glucose-lowering effect, occurs later, making this time less critical for monitoring.

Choice B reason: At 0730, only 30 minutes post-NPH insulin, the medication’s onset has not occurred, as it takes 1-2 hours to begin lowering glucose. Hypoglycemia is unlikely this early, as insulin levels are not yet significant. Peak effect at 4-12 hours is when monitoring is critical, making 0730 incorrect.

Choice C reason: NPH insulin peaks at 4-12 hours, with significant glucose-lowering effects by 1100 (4 hours post-0700 injection). Hypoglycemia risk is highest during this period due to insulin’s maximum activity, reducing blood glucose. Monitoring at 1100 is critical to detect and treat low glucose, preventing symptoms like tremors or seizures.

Choice D reason: At 0715, only 15 minutes post-NPH insulin, the medication has not reached its onset (1-2 hours). Hypoglycemia is unlikely, as insulin has not significantly lowered glucose. The peak effect at 4-12 hours is when hypoglycemia risk is highest, making 0715 an incorrect time for monitoring.