A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?
Obtain an influenza vaccine annually
Take glyburide with breakfast
Administer glucagon for hyperglycemia
Inject insulin in the deltoid muscle
The Correct Answer is A
Type 1 diabetes mellitus is a condition where the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Individuals with type 1 diabetes require insulin therapy to manage their blood sugar levels. Since the question is about teaching an adolescent with type 1 diabetes, let's analyze each option:
A) Obtain an influenza vaccine annually:
This is a crucial recommendation. People with diabetes, including type 1 diabetes, have a higher risk of complications from infections, including influenza (the flu). The flu can lead to elevated blood sugar levels and potentially worsen diabetes control. Getting an annual influenza vaccine helps reduce the risk of getting the flu and its associated complications.
B) Take glyburide with breakfast:
Glyburide is a medication used to treat type 2 diabetes, not type 1 diabetes. It stimulates the pancreas to produce more insulin. Type 1 diabetes is characterized by a lack of insulin production, so taking glyburide would not be appropriate.
C) Administer glucagon for hyperglycemia:
Glucagon is a hormone used to raise blood sugar levels, typically in cases of severe hypoglycemia (low blood sugar). It is not used to treat hyperglycemia (high blood sugar) in type 1 diabetes. Instead, insulin administration is the primary method for managing high blood sugar levels.
D) Inject insulin in the deltoid muscle:
Insulin injections for individuals with type 1 diabetes are typically given in the subcutaneous fat, which is found just beneath the skin. The deltoid muscle is not a recommended site for insulin injections due to inconsistent absorption. The abdomen, thighs, and buttocks are commonly recommended injection sites.
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Correct Answer is B
Explanation
A) Document intake and output:
Documenting intake and output is an important nursing task, but it is not the top priority in a suspected case of bacterial meningitis. Timely administration of antibiotics to treat the infection takes precedence over documentation of intake and output.
B) Administer antibiotics when available.
Explanation:
Bacterial meningitis is a serious and potentially life-threatening infection of the membranes covering the brain and spinal cord. Rapid administration of antibiotics is crucial to effectively treat the infection and prevent its spread. Delay in antibiotic administration can lead to worsening symptoms and complications. Therefore, getting the appropriate antibiotics to the child as soon as they are available is the nurse's priority.
C) Reduce environmental stimuli:
Reducing environmental stimuli can be helpful in managing symptoms and providing comfort to the child with meningitis, but it is not the priority action. The immediate concern in a suspected case of bacterial meningitis is to treat the infection.
D) Maintain seizure precaution:
While maintaining seizure precautions is important, especially if the child has a history of seizures, it is not the top priority in a suspected case of bacterial meningitis. Administering antibiotics to treat the infection and prevent its progression is the primary concern.
Correct Answer is A
Explanation
A. "I will continue to check his blood sugar two times every day."
Correct Explanation: This statement indicates a need for further instruction.
Explanation: A child with type 1 diabetes requires frequent blood sugar monitoring, especially during illness. Checking blood sugar only twice a day is not sufficient, especially when the child has an upper respiratory infection. Illness can impact blood sugar levels, so more frequent monitoring is necessary to ensure proper diabetes management.
B. "I will report a change in her breathing or any signs of confusion."
Incorrect Explanation: This statement shows awareness of potential complications and the need to monitor for them.
Explanation: Children with type 1 diabetes are at risk of diabetic ketoacidosis (DKA) when they are sick. Changes in breathing patterns and signs of confusion are symptoms of DKA. Reporting these symptoms is important, as it could indicate a serious diabetic complication.
C. "I will encourage her to drink half a cup of water or sugar-free fluid every 30 minutes."
Incorrect Explanation: This statement demonstrates proper fluid management, especially during illness.
Explanation: Encouraging the child to stay hydrated with sugar-free fluids is essential, particularly when the child has an upper respiratory infection. Proper hydration helps prevent dehydration, which can be more concerning for a child with diabetes.
D. "I will notify the doctor if her temperature is not controlled by acetaminophen."
Incorrect Explanation: This statement shows an understanding of the importance of managing fever in a child with diabetes.
Explanation: Children with diabetes can experience difficulty managing blood sugar levels when they're sick. Fever can exacerbate this issue. Using acetaminophen to control fever is appropriate, and notifying the doctor if fever persists is a responsible action.
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