A nurse is caring for a 7-year-old client who has an upper respiratory infection and a history of type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instruction?
"I will report changes in breathing or signs of confusion."
"I will encourage him to drink a half a cup of water or sugar-free fluid every 30 minutes."
"I will notify the doctor if his temperature is not controlled with acetaminophen."
"I will continue to check his blood sugar two times every day."
The Correct Answer is D
A. "I will report changes in breathing or signs of confusion." Correct action as changes in breathing or confusion can indicate diabetic ketoacidosis or other serious complications.
B. "I will encourage him to drink a half a cup of water or sugar-free fluid every 30 minutes."Ensuring adequate fluid intake helps prevent dehydration and helps manage blood sugar levels during illness.
C. "I will notify the doctor if his temperature is not controlled with acetaminophen." Correct action as fever may indicate an infection that needs further medical evaluation and treatment.
D. "I will continue to check his blood sugar two times every day." When a child with diabetes is ill, blood sugar should be monitored more frequently, typically every 3-4 hours, to manage the risk of hyperglycemia or hypoglycemia due to illness.
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Related Questions
Correct Answer is B
Explanation
A. Require that the child have antibiotic coverage. This answer is incorrect because immunizations do not typically require antibiotic coverage.
B. Should be delayed. Prednisone can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, immunizations should be delayed until the child has completed the course of prednisone and their immune system has recovered.
C. Can interfere with the treatment for nephrosis. While prednisone can be part of nephrotic syndrome treatment, immunizations are not known to interfere directly with this treatment.
D. Can be given in smaller, divided doses. This answer is incorrect because the issue isn't about the size or frequency of the vaccine doses but rather about the timing relative to the child's immunosuppressive treatment.
Correct Answer is C
Explanation
A. Take the prescribed insulin 30 minutes before practice or game time rather than in the morning. Insulin timing should generally be consistent with meal times to match insulin action with food intake. Adjusting timing without medical advice can lead to imbalanced blood sugar levels.
B. Eat half the amount of food normally eaten at lunchtime. Eating less food than usual can lead to hypoglycemia during prolonged physical activity and is not recommended.
C. Eat six graham crackers or drink a cup of orange juice before practice or game time. This action helps to prevent hypoglycemia during physical activity by providing quick-acting carbohydrates that can be readily absorbed and utilized by the body.
D. Take two times the amount of prescribed insulin on practice and game days. Doubling insulin doses without medical supervision can lead to hypoglycemia and is not appropriate for managing blood sugar during physical activity.
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