At a 2 year old well child exam the nurse is giving anticipatory guidance related to prevention of accidental ingestions to the parents. Which statement by the parents demonstrates understanding.

Rationale:

A. "Air passages are more likely to become blocked with mucus because younger children make more mucus than do older children": Younger children are not constantly producing more mucus than older children. The increased risk is more related to anatomical and physiological differences rather than baseline mucus volume.

B. "Airways structures are closer together so infection spreads faster in the young child": In toddlers, airway structures are smaller and in closer proximity, allowing pathogens to quickly move from one area to another. This proximity, combined with immature immune defenses, increases the likelihood of widespread infection and associated complications.

C. "Younger children have more exposure to respiratory illnesses": While young children may be exposed frequently in settings like daycare, exposure alone does not explain increased severity or complications. The higher risk is due to their developing respiratory anatomy and immune system.

D. "Toddlers do not breathe as deeply as do older children": Tidal volume in toddlers is smaller due to their smaller lung size, but this factor alone does not significantly explain their increased risk of complications from infection.

Rationale:

A. We will make sure that we have enough metformin when we go on vacation: Metformin is an oral antidiabetic medication used for type 2 diabetes, not type 1. A child with type 1 diabetes will require insulin for glucose control.

B. We may have to check blood sugars more frequently when he is sick: Illness can raise blood glucose levels due to stress hormones, so more frequent monitoring helps guide insulin adjustments and prevent complications like diabetic ketoacidosis (DKA).

C. We should rotate insulin injection sites frequently to reduce scar tissue forming: Repeated injections in the same location can cause lipodystrophy (scar tissue or fat changes) which can impair insulin absorption. Rotating sites helps maintain consistent medication effectiveness.

D. We will check glucose levels once he starts to eat: Glucose monitoring for type 1 diabetes is often done before meals, not just after eating. Pre-meal checks guide insulin dosing and help maintain better blood glucose control.

E. We will always need to check ketones when his blood sugar is above 100: This is incorrect because ketone testing is not needed at such a low blood sugar threshold. Ketone testing is typically done when glucose levels are above 240 mg/dL or if the child is ill, to monitor for DKA risk.