The diabetes educator has completed his teaching with a family and 13 year old child with newly diagnosed type 1 diabetes. The nurse knows the teaching has been effective when the child states:
“I can skip checking my blood sugar at noon if I am not going to eat lunch”
“When I am sick i probably will not need as much insulin as usual”
“When i feel irritable, sweaty, and shaky I should check my blood sugar because it might be high”
“When I feel thirsty and have a stomach ache I should check my blood sugar because my sugar might be high”
The Correct Answer is D
A. Skipping blood sugar checks could lead to undetected hypo- or hyperglycemia, so regular checks are essential.
B. Illness typically requires more insulin, not less, as the body is under stress.
C. Irritability, sweating, and shakiness are more likely signs of hypoglycemia, not hyperglycemia.
D. Thirst and stomach aches are common symptoms of hyperglycemia, so the child should check blood sugar when experiencing these signs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Checking temperature is important, but these signs are more concerning for cardiac decompensation rather than infection.
B. The child may be experiencing heart failure or respiratory distress. Alerting the physician is the appropriate action to assess for worsening condition.
C. Increasing the oxygen rate might be necessary, but the priority is alerting the physician first for further assessment.
D. Withholding oral feeding may be necessary, but the priority is physician notification to guide management.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A","dropdown-group-3":"A","dropdown-group-4":"E","dropdown-group-5":"E"}
Explanation
Based on the available test results, the nurse suspects the child may be experiencing diabetic ketoacidosis because of ketones and glucose in the urine. The nurse anticipates that the child will need IV fluid replacement and IV regular insulin as soon as possible.
Rationale:
Diabetic ketoacidosis (DKA): The presence of both glucose (over 500 mg/dL) and ketones in the urine is a key indicator of diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes mellitus, particularly type 1, where the body starts breaking down fats due to a lack of insulin, resulting in the production of ketones. When ketones build up in the blood, it leads to metabolic acidosis and a variety of other complications.
Ketones: High levels of ketones in the urine indicate that the body is unable to use glucose for energy and is instead breaking down fat. This is common in DKA, where the lack of insulin leads to fat breakdown and ketone production.
Glucose: The presence of glucose in the urine (glucosuria) suggests hyperglycemia, which is another hallmark of diabetes mellitus and typically present in diabetic ketoacidosis.
Treatment:
IV fluid replacement: In DKA, dehydration is common due to excessive urination from high blood sugar. IV fluids are administered to rehydrate the body and restore normal fluid and electrolyte balance.
IV regular insulin: Regular insulin is essential to lower the blood glucose level and stop the body from producing ketones. Insulin is administered via IV to quickly bring the glucose levels under control and prevent further production of ketones.
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