A nurse is caring for an 11-year-old child who has type 1 diabetes mellitus and receives insulin injections. The child is experiencing an altered mental status, diaphoresis, and tremors. Which of the following actions should the nurse take?
Give the child 3 to 6 oz of orange juice.
Give the child a candy bar.
Administer glucagon to the vastus lateralis.
Administer DSW intravenous fluids.
The Correct Answer is A
A. Give the child 3 to 6 oz of orange juice. The child's altered mental status, diaphoresis, and tremors indicate hypoglycemia. The best initial treatment for mild to moderate hypoglycemia is a fast-acting carbohydrate, such as orange juice (3 to 6 oz) to rapidly raise blood glucose levels.
B. Give the child a candy bar. While candy contains sugar, it also contains fat, which slows glucose absorption, delaying the correction of hypoglycemia.
C. Administer glucagon to the vastus lateralis. Glucagon is used for severe hypoglycemia (e.g., unconsciousness or seizures), not for mild to moderate symptoms.
D. Administer D5W intravenous fluids. IV dextrose is used in severe cases where the child is unconscious or unable to take oral glucose. Since this child is conscious, oral treatment is preferred.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","F","G"]
Explanation
Capillary refill 4 seconds (Cardiovascular) – Indicates poor perfusion and worsening dehydration.
Extremities cool (Integumentary) – Suggests impaired circulation, potential hypovolemia.
Reports no tears (Integumentary) – Sign of severe dehydration.
Lethargic (Neurologic) – Worsening mental status, could indicate hypovolemia or electrolyte imbalance.
Heart rate 112/min – Mildly elevated but not yet critical.
Respiratory rate 26/min – Within an acceptable range for a toddler.
Hyperactive bowel sounds – Expected with diarrhea.
Diaper area reddened – Needs care but not urgent
Correct Answer is B
Explanation
A. "Apply scented baby powder to absorb residual moisture." Scented products can irritate the vaginal area and worsen symptoms of vulvovaginitis. Instead, keeping the area dry and clean is recommended.
B. "Apply a warm, moist compress three times per day." Warm compresses help soothe irritation and reduce inflammation associated with vulvovaginitis.
C. "Wear a feminine deodorant pad for vaginal drainage." Deodorant pads contain chemicals that can further irritate the area. Instead, using unscented pads or breathable cotton underwear is recommended.
D. "Wear nylon underwear at night." Nylon traps moisture and heat, which creates an environment for bacterial and fungal growth. Instead, wearing loose-fitting cotton underwear or sleeping without underwear is recommended to promote airflow and prevent irritation.
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