Antiemetics are ordered to control nausea and vomiting in the child undergoing chemotherapy. How can the nurse most effectively use these medications?

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.

A. This is a form of regression is incorrect because regression involves reverting to behaviors from an earlier developmental stage (e.g., bedwetting or thumb-sucking) often triggered by stress or illness. Having an imaginary friend is a normal developmental behavior in preschoolers and is not considered regression.

B. Preschool-aged children (ages 3–6) are in Piaget’s preoperational stage and Erikson’s initiative vs. guilt stage, during which imaginative and symbolic play is typical. Imaginary friends are a common expression of magical thinking and creativity, allowing children to explore social roles, practice problem-solving, and express emotions in a safe, controlled way. This behavior is developmentally appropriate and usually does not indicate a psychological problem.

C. Inclusion of imaginary friends may indicate lack of parental attention is incorrect because the presence of imaginary friends is not a sign of neglect or lack of attention. It is a normal aspect of imaginative play, even in children who receive adequate parental interaction and support.

D. She needs to seek psychiatric help for her daughter is incorrect because the presence of an imaginary friend in a preschooler is not pathological. Unless accompanied by other concerning behaviors (e.g., social withdrawal, aggression, developmental regression), it is considered a normal developmental phenomenon.