A nurse is performing a physical assessment for a school-age child who has acute glomerulonephritis. Which of the following findings should the nurse expect?

A. Withholding insulin when the child has a poor appetite can lead to hyperglycemia and diabetic ketoacidosis since insulin is still needed during illness even if intake is reduced. Illness typically increases stress hormones, which raise blood glucose levels, making insulin even more necessary.

B. Offering 20 grams of carbohydrates every 2 hours might not be sufficient or appropriate for all children; carbohydrate intake should be balanced with insulin and blood glucose monitoring. Proper carbohydrate intake helps maintain energy and prevent hypoglycemia, especially if the child is eating less than usual.

C. Increasing fluid intake is important during illness to prevent dehydration and help manage blood glucose levels, as illness can cause increased glucose levels and fluid loss. Adequate hydration also supports kidney function and helps flush excess glucose from the bloodstream.

D. Monitoring blood glucose every 8 hours is too infrequent during illness; blood glucose should be checked every 3 to 4 hours to detect and manage hyperglycemia or hypoglycemia promptly. Frequent monitoring allows timely insulin dose adjustments and early intervention.

A. Gymnastics: This sport involves a high risk of falls and joint injuries, which can cause bleeding episodes in children with hemophilia and should generally be avoided.

B. Bowling: Bowling is a low-impact sport with minimal risk of trauma or injury, making it safer and more appropriate for children with hemophilia to participate in.

C. Basketball: This is a high-impact, contact sport with a significant risk of collisions and falls, increasing the chance of bleeding episodes in hemophilia.

D. Soccer: Soccer involves running, sudden stops, and physical contact, which can increase the risk of injuries and bleeding in children with hemophilia.