The nurse is reviewing fetal circulation with parents after the diagnosis of a heart defect. Which statement by the nurse is correct?

Rationale:

A. Suprasternal retractions occurs at the notch above the sternum, not below it.

B. Supraclavicular retractions are seen above the clavicles, often with severe distress.

C. Intercostal retractions appear between the ribs, not beneath the sternum.

D. Substernal retractions occur just below the sternum when the child is working hard to breathe.

E. Subcostal retractions are located beneath the rib cage, closer to the abdomen, not at the sternum.

Rationale:

A. Metformin twice a day, taken with food to prevent GI upset: Metformin is the first-line medication for Type 2 Diabetes and helps improve insulin sensitivity. Taking it with food reduces gastrointestinal side effects, making this a key part of treatment.

B. Long acting lantus before bed to control blood sugar overnight: While insulin may be necessary in some Type 2 Diabetes cases, especially with significant hyperglycemia, it is not typically the initial treatment for newly diagnosed adolescents. It is more common in Type 1 Diabetes or advanced Type 2.

C. Rapid Acting Insulin dosed using a sliding scale before every meal: Sliding scale insulin is generally reserved for Type 1 Diabetes or severe cases of Type 2 Diabetes with uncontrolled glucose. It is not the standard initial treatment in newly diagnosed Type 2 adolescents.

D. Consistent aerobic exercise every day with a goal of 60 minutes per day: Regular physical activity is essential in managing Type 2 Diabetes as it improves insulin sensitivity and aids in weight management.

E. Regular blood sugar monitoring throughout the day: Monitoring blood glucose levels helps track the effectiveness of treatment and guides lifestyle or medication adjustments in Type 2 Diabetes management.

F. Use of a continuous subcutaneous insulin pump to control blood sugar: Insulin pumps are typically used for Type 1 Diabetes. Their use in Type 2 Diabetes is rare and usually reserved for specific cases, not standard treatment.

G. Well balanced diet and monitoring simple sugar intake: Dietary management focusing on balanced nutrition and limiting simple sugars is fundamental in controlling Type 2 Diabetes and preventing glucose spikes.