A nurse is caring for a toddler who received radiation therapy 2 years ago for a brain tumor. Which of the following should the nurse identify as a late adverse effect of the radiation therapy?

A. "As I get older, my sugar levels will automatically decrease.": Blood glucose control does not improve with age. In fact, hormonal changes during adolescence can make glucose management more challenging, requiring close monitoring and insulin adjustments.

B. "As long as I take my insulin, I can eat whatever I want.": Even with insulin therapy, diet management is essential in type 1 diabetes. Consuming excessive carbohydrates or unhealthy foods can lead to poor glycemic control and increase the risk of long-term complications.

C. "I will increase my food intake before I exercise.": Physical activity lowers blood glucose levels, and adolescents with type 1 diabetes are at risk for hypoglycemia during or after exercise. Increasing carbohydrate intake before exercise helps maintain stable glucose levels and prevent hypoglycemia.

D. "The blood pressure medicine I'm taking will help to keep my insulin level low.": Antihypertensive medications are not used to regulate insulin or glucose levels. They may be prescribed for other conditions, but they do not play a role in type 1 diabetes management.

A. Auscultate the abdomen for at least 1 min if bowel sounds are absent: If bowel sounds are absent, the nurse should listen for a full 5 minutes before determining true absence. Listening for only 1 minute may lead to an inaccurate conclusion.

B. Observe abdominal movement to determine the respiratory rate: Abdominal movement is observed for respiratory assessment in infants and younger children. By adolescence, chest movement is more reliable for assessing respiratory rate.

C. Use the FACES scale to assess pain: The FACES scale is typically used for younger children who may struggle with numeric rating scales. A 13-year-old adolescent can generally use a numeric scale (0–10) for accurate self-reporting of pain.

D. Have the child bend forward at the waist and check for asymmetry of the scapula: This is an appropriate screening method for scoliosis in adolescents. Bending forward allows the nurse to detect uneven shoulders, hips, or scapulae, which are common indicators of spinal curvature.