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 A
Explanation
A. "I will keep my baby in an upright position after feeding." Keeping the infant upright after feedings helps reduce reflux by utilizing gravity to keep the stomach contents from coming back up into the esophagus.
B. "I will have to feed my baby formula, rather than breast milk." Breast milk is actually preferred for infants with reflux as it is digested more quickly than formula, which may reduce reflux episodes.
C. "My baby's formula can be thickened with oatmeal." While thickening feeds can help in some cases, it's generally done with rice cereal under the guidance of a healthcare provider. Oatmeal is not typically recommended for thickening formula for young infants.
D. "I should move my baby into a side-lying position during sleep." Side-lying position is not recommended for sleep due to the risk of sudden infant death syndrome (SIDS). The baby should be placed on their back to sleep.
Correct Answer is A
Explanation
A. Initiate isotonic fluids with 20 mEq/L potassium chloride. The priority in treating acute gastroenteritis in a toddler is to manage dehydration, which is often severe due to fluid loss from vomiting and diarrhea. Isotonic fluids with electrolytes like potassium chloride help to restore fluid balance and prevent complications like electrolyte imbalances. This is the most urgent action to stabilize the child's condition.
B. Request evaluation of the toddler's serum electrolytes. While important, this can be done after fluid resuscitation has begun to assess the severity of electrolyte imbalances.
C. Determine if the toddler is voiding. Important for assessing renal function, but not the first priority in acute gastroenteritis.
D. Collect a stool sample from the toddler. Useful for identifying the causative organism but not as urgent as fluid resuscitation.
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