A nurse is planning discharge teaching for an adolescent who has a new diagnosis of type 1 diabetes mellitus. Which of the following information should the nurse include in the plan?

Drink 8 oz of milk when hypoglycemia develops.

Initiate a 1,400-calorie diet daily.

Rotate the insulin injection site to a different area of the body with every other injection.

Keep unopened insulin refrigerated at 4.44° C (40° F).

Answer and Explanation

The Correct Answer is D

A) Drink 8 oz of milk when hypoglycemia develops:
While consuming a fast-acting carbohydrate is important during hypoglycemia, 8 oz of milk may not be the most effective choice. Typically, glucose tablets or juice are recommended as they provide a quicker absorption of sugar into the bloodstream.

B) Initiate a 1,400-calorie diet daily:
Caloric needs should be individualized based on the adolescent’s age, weight, activity level, and overall health. A fixed 1,400-calorie diet might not be appropriate for every adolescent and could lead to insufficient energy intake or excessive restriction.

C) Rotate the insulin injection site to a different area of the body with every other injection:
While rotating injection sites is important to prevent lipodystrophy, it is generally recommended to use different sites within the same area (such as different spots on the abdomen) rather than entirely different areas of the body with each injection. This ensures consistent absorption of insulin.

D) Keep unopened insulin refrigerated at 4.44° C (40° F):
Unopened insulin should be stored in the refrigerator to maintain its potency until it is ready to be used. This temperature range ensures the insulin remains stable and effective for use.

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Correct Answer is B

Explanation

A) "I will offer my child apple juice instead of milk.": Offering apple juice instead of milk is not ideal for a toddler with failure to thrive. Milk is a better source of essential nutrients like calcium and vitamin D, which are important for growth and development. Juice can contribute to empty calories and should be limited.

B) "I should continue to feed my child when he pushes food out with his tongue.": This statement indicates an understanding of the importance of addressing feeding difficulties. In toddlers with Down syndrome, it is common to experience difficulties with feeding and swallowing. Continuing to offer food and using techniques to encourage eating, even when the child initially pushes food out, can help ensure adequate nutritional intake and support growth.

C) "I will provide his favorite food as a reward for good behavior.": Using food as a reward can lead to unhealthy eating habits and an association of food with behavior rather than hunger and nutrition. It’s better to use non-food rewards to encourage positive behavior.

D) "I should increase my child's vitamin A intake by feeding him raw carrot slices.": While vitamin A is important, raw carrots can be difficult for toddlers, especially those with developmental delays or oral-motor difficulties, to chew and swallow. Cooked carrots or other vitamin A-rich foods might be a safer option.

A. Ibuprofen B. Tramadol C. Ketorolac D. Aspirin

Correct Answer is B

Explanation

A) Ibuprofen: While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, it is not the best choice for a client with a history of peptic ulcer disease. NSAIDs can exacerbate gastrointestinal issues and increase the risk of ulcer complications.

B) Tramadol: Tramadol is a moderate pain reliever that is not an NSAID and does not have the gastrointestinal side effects associated with NSAIDs. It is a suitable choice for short-term pain management in clients with a history of peptic ulcer disease, as it does not increase the risk of ulcer complications.

C) Ketorolac: Ketorolac is a potent NSAID used for short-term pain management. It is not recommended for clients with a history of peptic ulcer disease due to its high risk of causing gastrointestinal bleeding and exacerbating ulcer conditions.

D) Aspirin: Aspirin is an NSAID and has a high potential to irritate the gastrointestinal tract, which can worsen peptic ulcer disease and lead to complications such as bleeding. It is generally avoided in clients with a history of peptic ulcers.

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A nurse is planning discharge teaching for an adolescent who has a new diagnosis of type 1 diabetes mellitus. Which of the following information should the nurse include in the plan?

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