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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale:
Administering oral rehydration solution (ORS) is a crucial nursing intervention for a dehydrated child.
ORS helps replenish the lost fluids and electrolytes, making it an effective treatment for dehydration.
Choice B rationale:
Keeping the child in a cold environment is not an appropriate intervention for a dehydrated child.
Dehydration is not related to room temperature, and maintaining a comfortable environment is important, but extreme cold could cause discomfort to the child.
Choice C rationale:
Monitoring the child's vital signs is an essential nursing intervention when caring for a dehydrated child.
Vital signs, including heart rate, respiratory rate, blood pressure, and temperature, can provide important information about the child's condition and hydration status.
Regular monitoring helps in assessing the child's progress and identifying any worsening symptoms.
Choice D rationale:
Providing heavy meals at regular intervals is not an appropriate intervention for a dehydrated child.
As mentioned earlier, heavy meals can be difficult to digest and may worsen dehydration.
It is more important to focus on rehydration with fluids like ORS.
Choice E rationale:
Educating the child and caregivers about dehydration is an important nursing intervention.
Teaching them about the signs and symptoms of dehydration, the importance of ORS, and how to prevent it in the future is essential for the child's well-being and for preventing future episodes of dehydration.
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.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.