A nurse is caring for a 3-year-old child who was admitted with acute diarrhea and dehydration. Which of the following findings indicates that oral rehydration therapy has been effective?

The correct answer is D) A child whose parents answer questions for the child.

Here is a detailed explanation for each choice:

Choice A reason:

A child who has a BMI indicating obesity: While obesity can be a concern for a child’s health, it is not a direct indicator of abuse. Obesity can result from various factors, including genetics, diet, and physical activity levels. It does not necessarily suggest that the child is experiencing abuse or neglect.

Choice B reason:

A child who has frequent visitors: Frequent visitors can indicate a strong support system and concern for the child’s well-being. It is not typically associated with abuse. In fact, children who are abused often have fewer visitors and less social support.

Choice C reason:

A child who uses the call light frequently: Frequent use of the call light may indicate that the child is seeking attention or has unmet needs, but it is not a specific indicator of abuse. Children may use the call light for various reasons, including anxiety, pain, or a need for reassurance.

Choice D reason:

A child whose parents answer questions for the child: This behavior can be a red flag for abuse. When parents consistently answer questions for the child, it may indicate that they are controlling the child’s communication and preventing them from speaking freely. This can be a sign of emotional abuse or manipulation.

Choice A reason: Tremors are not a likely finding in a child with hyperglycemia, or high blood glucose. Tremors are more commonly associated with hypoglycemia, or low blood glucose, as the body releases adrenaline to stimulate the release of glucose from the liver. Tremors may also be caused by anxiety, caffeine, or certain medications.

Choice B reason: Shallow respirations are not a likely finding in a child with hyperglycemia, unless the child has developed diabetic ketoacidosis (DKA), a serious complication of diabetes that occurs when the body breaks down fat for energy and produces ketones, which are acidic substances that can cause metabolic acidosis. In DKA, the child may have rapid and deep breathing, also known as Kussmaul respirations, as the body tries to eliminate excess carbon dioxide and acid. However, DKA usually occurs when the blood glucose level is above 300 mg/dL, and the child may also have other signs and symptoms, such as nausea, vomiting, abdominal pain, fruity breath, and confusion.

Choice C reason: Pallor is not a likely finding in a child with hyperglycemia, as the blood flow to the skin is not affected by high blood glucose. Pallor is more commonly associated with anemia, shock, or hypoxia, which are conditions that reduce the oxygen-carrying capacity of the blood or the blood flow to the tissues.

Choice D reason: Lethargy is a likely finding in a child with hyperglycemia, as high blood glucose can cause dehydration, electrolyte imbalance, and impaired brain function. The child may feel tired, weak, and drowsy, and have difficulty concentrating or staying awake. Lethargy may also indicate that the child is at risk of developing DKA, which can lead to coma and death if not treated promptly.