What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning?

Choice A reason: No activity restrictions are inappropriate in acute glomerulonephritis with edema, as exertion may worsen hypertension or renal strain. Gross hematuria indicates active glomerular inflammation, requiring limited activity to reduce cardiovascular stress and promote renal healing, making unrestricted activity an incorrect instruction for managing this condition.

Choice B reason: Limiting activity until gross hematuria subsides in acute glomerulonephritis reduces renal and cardiovascular stress, preventing exacerbation of hypertension or hematuria. Rest promotes glomerular healing by minimizing blood pressure spikes. This is the priority instruction, as hematuria signals active disease, requiring cautious management to prevent complications.

Choice C reason: A high-potassium diet (e.g., bananas) is contraindicated in acute glomerulonephritis, as impaired renal function may cause hyperkalemia, risking arrhythmias. Low-potassium diets are often recommended. Limiting activity addresses hematuria and hypertension, making high-potassium intake an incorrect and potentially harmful instruction for this condition.

Choice D reason: Bedrest for 2 weeks is excessive in acute glomerulonephritis, as most children recover with limited activity until hematuria resolves. Prolonged bedrest risks complications like thrombosis without evidence of benefit. Limiting activity based on hematuria is more targeted, making fixed bedrest an incorrect and overly restrictive instruction.

Choice A reason: Right-side positioning after feeding may reduce reflux in some infants but is less effective than upright positioning, which uses gravity to keep stomach contents down. Right-side lying also poses a sudden infant death syndrome risk, making it less ideal than upright positioning for managing gastroesophageal reflux in infants.

Choice B reason: Prone positioning is contraindicated for infants due to increased sudden infant death syndrome risk. It does not effectively reduce gastroesophageal reflux compared to upright positioning, which leverages gravity to prevent regurgitation. Prone positioning is unsafe and not recommended, making it an incorrect choice for reflux management.

Choice C reason: Left-side positioning is not optimal for gastroesophageal reflux, as it may not prevent stomach contents from refluxing into the esophagus. Upright positioning is more effective, using gravity to minimize regurgitation and esophagitis. Left-side lying also carries sleep-related risks, making it less appropriate than upright positioning.

Choice D reason: Upright positioning after feeding is optimal for gastroesophageal reflux, as gravity keeps stomach contents from refluxing into the esophagus, reducing regurgitation and esophageal irritation. This position minimizes aspiration risk and promotes comfort, making it the recommended choice for infants with reflux to prevent complications like esophagitis.