The nurse is caring for an adolescent with type 1 diabetes mellitus who presents with an HbA1c of 11% (97 mmol/mol), thirst, and blurred vision.

What action should the nurse take first?

Choice A rationale
Applying soft restraints to all four extremities of an infant is not typically recommended when initiating a peripheral intravenous (IV) infusion. Restraints can cause distress and may not be necessary for the procedure.
Choice B rationale
While the dorsal surface of the feet can be used as an IV site, it is not typically the first choice for infants. The veins in the feet can be difficult to access and the location can be inconvenient for the infant.
Choice C rationale
Instructing parents to sing or croon to the infant can be comforting and may help soothe the infant during the procedure. However, this action alone does not directly facilitate the successful initiation of an IV infusion.
Choice D rationale
Selecting a site that is least restrictive to the infant is the most appropriate action when initiating a peripheral IV infusion. This can make the procedure less distressing for the infant and allow for easier movement after the IV is in place.

Choice A rationale
The adolescent client’s symptoms of localized pain, swelling, and tenderness, particularly at night, are suggestive of a malignancy such as osteosarcoma, which is the most common primary bone tumor in children and adolescents. Radial ossification in the soft tissues is a characteristic finding in osteosarcoma and is indicative of bone production by malignant cells.
Choice B rationale
Hemosiderosis is a rare condition characterized by the accumulation of iron in various tissues, including the liver, spleen, and bone marrow. It may present with symptoms such as fatigue, joint pain, and abdominal pain, but is not typically associated with the symptoms and imaging findings described in the case scenario.
Choice C rationale
Growing pains are a common, benign condition that occur in children and do not typically present with the symptoms described in the case scenario.
Choice D rationale
Rhabdomyolysis is a medical emergency that involves the breakdown of skeletal muscle tissue and release of muscle fiber contents into the bloodstream. It can present with muscle pain, swelling, and tenderness, but typically occurs as a result of injury, infection, or drug toxicity.