A nurse is assessing a 7-year-old child who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
Increased capillary refill
Shakiness
Thirst
Decreased appetite
The Correct Answer is B
The correct answer is B. Shakiness.
Choice A: Increased capillary refill Capillary refill time (CRT) is a simple and quick test requiring minimal equipment or time to perform. Prolonged CRT is a ‘red flag’ feature, identifying children with increased risk of significant morbidity or mortality. A normal CRT should be between 2-3 seconds when applied centrally, such as to the sternum or the forehead. Therefore, increased capillary refill is not typically associated with hypoglycemia.
Choice B: Shakiness Shakiness, or tremors, are rhythmic shaking movements that most often happen in the hands, but can also occur in the arms, legs, head, vocal cords, and torso. Tremors can occur while a child is resting or active. Shakiness is a common symptom of hypoglycemia.
Choice C: Thirst While it’s true that excessive thirst can be a sign of diabetes, it’s a tricky one when the patient is a child. Young children often drink plenty of fluids when they are perfectly healthy. However, thirst is typically associated with hyperglycemia, not hypoglycemia.
Choice D: Decreased appetite Loss of appetite (anorexia) is a common symptom in children. Acute illness in childhood is often associated with transient loss of appetite. However, decreased appetite is not typically a direct symptom of hypoglycemia.
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Correct Answer is B
Explanation
Communicate with the healthcare team.
To ensure comprehensive care during the treatment and management of dehydration in children, communication with the healthcare team is essential.
Here's the rationale for this choice:
Choice A rationale:
Administer electrolyte solutions only.
This is not The correct approach.
While administering electrolyte solutions is a vital part of managing dehydration, it is not the only aspect of care.
Comprehensive care also includes assessing the child's overall condition, monitoring vital signs, and addressing any underlying causes of dehydration.
Choice B rationale:
Communicate with the healthcare team.
This is The correct answer.
Dehydration management often requires a multidisciplinary approach.
Communicating with the healthcare team, which may include physicians, dietitians, and other specialists, is crucial to ensure that the child receives appropriate treatment and that any underlying medical issues are addressed.
It also allows for coordinated care and adjustment of the treatment plan as needed.
Choice C rationale:
Rely solely on clinical signs to assess hydration status.
Relying solely on clinical signs is not sufficient for comprehensive care.
While clinical signs are important indicators of hydration status, laboratory tests and monitoring are also necessary to accurately assess and manage dehydration.
Choice D rationale:
Skip monitoring the child's response to treatment.
Skipping monitoring is not advisable.
Monitoring the child's response to treatment is a critical part of dehydration management.
It helps ensure that the child is improving, and adjustments can be made to the treatment plan if necessary.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale:
Assessing the degree of dehydration based on clinical signs and symptoms is a fundamental step in managing a dehydrated child.
This assessment guides the choice of appropriate treatment and fluid replacement.
Choice B rationale:
Calculating the fluid deficit based on the degree of dehydration is crucial in determining the amount of fluid that needs to be replaced accurately.
This calculation helps prevent under or overhydration.
Choice D rationale:
Monitoring the child's response to treatment and adjusting the plan accordingly is essential.
Dehydration management is an ongoing process, and adjustments may be necessary based on how the child is progressing.
Choice E rationale:
Communication with physicians, nutritionists, and other healthcare professionals is vital for comprehensive care.
Dehydration management often involves a multidisciplinary approach to address the child's overall health and nutritional needs.
Selecting all of these options (A, B, D, and E) ensures a comprehensive approach to managing dehydration in a child.
It involves assessment, calculation, monitoring, and collaboration with healthcare professionals for the best outcome.
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