A nurse is caring for a school-age child who has diabetes mellitus. Which of the following findings should the nurse recognize as being consistent with hyperglycemia?

A. Apply plastic covering to the cast until dry. Covering the cast with plastic can cause moisture accumulation, which can delay drying and increase the risk of infection and skin irritation. The cast should be allowed to dry naturally and in a well-ventilated area.

B. Apply pieces of moleskin around the edges of the cast. Applying moleskin around the edges of the cast helps to protect the skin from irritation and potential injury from the rough edges of the cast. This is an appropriate intervention.

C. Use tips of fingers to reposition the cast until dry. Using the tips of fingers to handle the cast while it is drying can create indentations, leading to pressure points and potential skin breakdown. The cast should be handled with the palms of the hands to avoid indentations.

D. Maintain casted extremity below heart level. The casted extremity should be elevated above heart level, especially in the first 24-48 hours, to reduce swelling and promote venous return. Keeping it below heart level can increase swelling.

A. The child exhibits a gag reflex when stimulated with a tongue blade. The gag reflex is associated with cranial nerves IX (glossopharyngeal) and X (vagus), not the trigeminal nerve.

B. The child maintains balance when standing with eyes closed. Balance is assessed in part by cranial nerve VIII (vestibulocochlear nerve) and also involves the cerebellum, not the trigeminal nerve.

C. The child correctly identifies specific scents. Identifying specific scents is related to cranial nerve I (olfactory nerve), not the trigeminal nerve.

D. The child has symmetrical jaw strength when biting down. The trigeminal nerve (cranial nerve V) controls the muscles of mastication. Symmetrical jaw strength when biting down indicates proper functioning of this nerve.