A nurse is teaching a child with type 1 diabetes mellitus how to self-inject insulin. Which method should she recommend to the child for regular doses?
Intravenously in the chest
Subcutaneously in the outer thigh
Intramuscularly in the abdomen
Intradermally in the outer arm
The Correct Answer is B
A. Insulin is rarely given intravenously except in acute hospital settings (e.g., DKA management) under strict monitoring. IV administration by a child at home is unsafe and inappropriate due to the risk of hypoglycemia, infection, and vascular complications. The chest is also not a recommended site for injections.
B. Subcutaneous injections are the preferred route for regular insulin administration at home. Insulin is absorbed more slowly from subcutaneous tissue, providing a steady onset of action and reducing the risk of rapid hypoglycemia. The outer thigh, abdomen, upper arms, and buttocks are common subcutaneous injection sites, with the outer thigh often recommended for self-injection in children due to accessibility and ease of rotation to prevent lipodystrophy.
C. Intramuscular injections are not recommended for routine insulin administration because absorption is faster and less predictable, increasing the risk of hypoglycemia. The abdomen is not a typical intramuscular injection site; IM insulin injections are generally avoided except in specific clinical settings under supervision.
D. Intradermal injections deliver medication into the dermis, not subcutaneous tissue. This route is used for allergy testing or tuberculosis screening, not for insulin administration, as it does not allow for proper absorption and therapeutic effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hydration is essential because dehydration increases blood viscosity, promoting sickling of red blood cells and vaso-occlusion. Parents should be instructed to encourage regular fluid intake throughout the day, even when the child does not feel thirsty. Proper hydration helps prevent painful crises and reduces the risk of organ damage.
B. Children with SCA are at increased risk for infections due to functional asplenia. Immunizations are essential to prevent serious infections, such as pneumococcal and meningococcal disease. Avoiding vaccines would increase infection risk.
C. Physical activity should be encouraged but with caution. Children should avoid extreme exertion or high-altitude activities that could lead to hypoxia, dehydration, or fatigue, which can precipitate sickle-cell crises.
D. While mild symptomatic relief may be appropriate, children with SCA require prompt evaluation for infections, particularly fevers, because even minor infections can trigger complications. Self-treatment without medical guidance may delay critical interventions.
Correct Answer is C
Explanation
A. Antibiotics are only indicated if a bacterial infection is diagnosed, such as sinusitis. Chronic progressive headaches are usually not caused by bacterial infections, so empiric antibiotic therapy is not appropriate.
B. Referral to a counselor or psychiatric evaluation may be considered if psychosocial factors contribute to headache, but it is not a primary treatment for chronic progressive headaches unless indicated by assessment.
C. Chronic progressive headaches, especially migraines, are often managed with preventive pharmacologic therapy to reduce the frequency and severity of episodes. Discharge instructions would include prescription medications, education on proper use, potential side effects, and lifestyle modifications to prevent triggers. This intervention directly addresses the child’s ongoing headache management.
D. Imaging such as a CT scan is typically reserved for cases with red flag symptoms (sudden onset, neurological deficits, vomiting, altered consciousness) or unclear etiology. It is not routinely included in discharge instructions for known chronic progressive headaches without concerning features.
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