What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness?
Give the child half his regular morning dose of insulin
Substitute simple carbohydrates or calorie-containing liquids for solid foods
Give the child plenty of unsweetened, clear liquids to prevent dehydration
Take the child directly to the emergency department
The Correct Answer is B
The child should receive his regular dose of insulin even if he does not have an appetite. If the child is not eating as usual, he needs calories to prevent hypoglycemia. During periods of minor illness, the child with type 1 diabetes mellitus can be managed safely at home.
Choice A is wrong because giving the child half his regular morning dose of insulin can lead to hyperglycemia and ketoacidosis.
Choice C is wrong because giving the child plenty of unsweetened, clear liquids to prevent dehydration can also cause hypoglycemia.
Choice D is wrong because taking the child directly to the emergency department is not necessary unless the child has signs of severe dehydration, vomiting, abdominal
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Correct Answer is D
Explanation
Digoxin is a medication that helps improve the pumping function of the heart and reduces fluid retention in the lungs and other tissues. It is commonly used to treat congestive heart failure in infants.
Choice A is wrong because weighing the infant every day on the same scale at the same time is a way to monitor fluid balance, not an intervention to treat excess fluid volume.
Choice B is wrong because notifying the physician when weight gain exceeds more than 20 g/day is also a monitoring measure, not an intervention. Moreover, weight gain may not accurately reflect fluid volume status in some patients with heart failure due to poor nutrition and decreased appetite.
Choice C is wrong because putting the infant in a car seat to minimize movement may worsen the respiratory distress and increase the workload of the heart. The infant should be positioned in a semi-Fowler’s or Fowler’s position to facilitate breathing and reduce venous return.
Correct Answer is A
Explanation
This is a normal respiratory change in pregnancy caused by elevated levels of estrogen. Estrogen increases blood flow and causes the nasal mucosa to swell, leading to congestion and nosebleeds. This condition is called pregnancy rhinitis and affects up to 20% of pregnant women.
Choice B is wrong because this is not an abnormal cardiovascular change, and the nosebleeds are not an ominous sign. They are usually harmless and do not affect the pregnancy outcome.
Choice C is wrong because there is no evidence that the woman is a victim of domestic violence.
This is a serious accusation that should not be made without proper assessment and screening.
Choice D is wrong because there is no indication that the woman has been using cocaine intranasally. Cocaine use can cause nasal damage and bleeding, but it can also have other signs and symptoms such as agitation, euphoria, dilated pupils, increased heart rate and blood pressure, and risk of miscarriage or preterm labor.
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