The nurse is caring for a hospitalized child newly diagnosed with type 1 diabetes mellitus. At 1100, the child suddenly complains of weakness, headache, and blurred vision. How would the nurse respond?
Give the child 1⁄2 cup of orange juice to drink.
Call the dietary department and ask that the lunch tray be delivered early.
Contact the physician.
Obtain a blood glucose reading
The Correct Answer is A
A. Give the child 1⁄2 cup of orange juice to drink. These symptoms indicate hypoglycemia, a common early complication of diabetes treatment. Orange juice contains quick-acting sugars that can rapidly raise blood glucose levels and alleviate symptoms. This is the immediate action to manage the child's symptoms.
B. Call the dietary department and ask that the lunch tray be delivered early. Delayed action compared to treating the immediate hypoglycemia.
C. Contact the physician. While eventually necessary, immediate treatment of hypoglycemia takes precedence.
D. Obtain a blood glucose reading. Important to confirm hypoglycemia but not as urgent as providing immediate treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Maintain a saline-lock.Maintaining a saline lock is important for potential intravenous access, but it is not the most urgent priority compared to actions that directly monitor the child's condition and help manage the disease.
B. Parental education is important for long-term management and understanding of the condition, but it is not the most immediate priority in the acute phase of the illness.
C. A no-salt-added diet is important to help manage fluid retention and hypertension, which are common in acute glomerulonephritis. However, while important, it does not take immediate priority over assessing the child's fluid status.
D. Monitoring daily weight is crucial in acute glomerulonephritis, as it helps assess fluid balance and detect early signs of fluid retention or worsening kidney function, which are key concerns in this condition. This makes it a priority action.
Correct Answer is ["3.1"]
Explanation
First, convert the child's weight from pounds to kilograms:
22lb÷2.2=10kg
Calculate the dose:
10kg×10mg/kg=100mg
Next, calculate how many mL of acetaminophen liquid (160 mg/5 mL) is needed for 100 mg:
100mg÷160mg/5ml= 100 ×5/160= 3.125ml
Rounded to the nearest tenth, administer 3.1 mL (since the medication is typically measured in tenths).
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