A nurse is caring for a toddler who has a fractured right femur and is in Bryant traction. When determining that the traction is appropriately assembled, the nurse should observe which of the following?

Choice A reason: The onset of low blood glucose, or hypoglycemia, usually occurs rapidly and can be triggered by skipping meals, exercising too much, or taking too much insulin. The nurse should teach the parents to recognize the signs and symptoms of hypoglycemia and how to treat it promptly.

Choice B reason: Feeling shaky is one of the common signs of low blood glucose, along with hunger, sweating, dizziness, confusion, and irritability. The nurse should teach the parents to check the child's blood glucose level and give him a fast-acting carbohydrate, such as juice, candy, or glucose tablets, if it is below 70 mg/dL.

Choice C reason: Sweating can occur with low blood glucose, not high blood glucose, or hyperglycemia. Hyperglycemia can cause symptoms such as thirst, frequent urination, dry mouth, blurred vision, and fatigue. The nurse should teach the parents to monitor the child's blood glucose level regularly and adjust his insulin dose, diet, and exercise accordingly.

Choice D reason: Nausea and vomiting can occur with high blood glucose, especially if it leads to diabetic ketoacidosis, a serious complication of diabetes. Diabetic ketoacidosis can also cause abdominal pain, fruity breath, rapid breathing, and coma. The nurse should teach the parents to seek emergency medical attention if the child has these symptoms.

Choice A reason: This is not a correct instruction for the nurse to include in the teaching. Emphasizing the quantity, rather than the quality, of food consumed may lead to overeating, obesity, or malnutrition. The nurse should encourage the mother to offer a variety of healthy foods in appropriate portions and avoid forcing or bribing the child to eat.

Choice B reason: This is not a correct instruction for the nurse to include in the teaching. Expecting that food consumption might not decrease significantly may cause the mother to ignore the signs of poor nutrition or growth in the child. The nurse should advise the mother to monitor the child's weight, height, and development regularly and consult the provider if there are any concerns.

Choice C reason: This is a correct instruction for the nurse to include in the teaching. Adding fruit juice to the child's diet can increase the vitamin intake, especially vitamin C, which is important for immune function and wound healing. The nurse should recommend the mother to choose 100% fruit juice and limit the amount to 4 to 6 oz per day.

Choice D reason: This is not a correct instruction for the nurse to include in the teaching. Having the child remain at the table after meals to increase food intake may create a negative association with eating and cause more resistance or frustration. The nurse should suggest the mother to make mealtime a pleasant and relaxed experience and respect the child's appetite and preferences.