Which of the following food choices contains the least amount of phenylalanine for children with PKU?

Choice A reason:

Performing an ultrasound to determine if there is urinary retention is not the immediate priority action. While an ultrasound can help assess urinary retention, the presence of edema, redness, and the foreskin being behind the glans penis suggests a condition known as paraphimosis. Paraphimosis is a medical emergency that requires prompt attention to prevent complications such as tissue damage. Therefore, alerting the ER physician is the priority action.

Choice B reason:

Asking the parents specifically how long the infant has not voided is important for gathering information, but it is not the immediate priority action. The clinical signs of edema, redness, and the foreskin being behind the glans penis indicate a potential emergency that requires immediate medical intervention. While obtaining a detailed history is important, the nurse should first alert the ER physician to ensure timely management.

Choice C reason:

Alerting the ER physician to the patient’s condition is the correct priority action. The presence of edema, redness, and the foreskin being behind the glans penis suggests paraphimosis, which is a urological emergency. Prompt intervention is necessary to reduce the foreskin and restore normal blood flow to prevent tissue damage3. The ER physician can provide the necessary treatment and management for this condition.

Choice D reason:

Continuing to monitor the patient in the ER setting is not appropriate without first addressing the potential emergency. The signs of edema, redness, and the foreskin being behind the glans penis indicate a condition that requires immediate medical attention. Monitoring alone is insufficient; the nurse must alert the ER physician to ensure prompt intervention.

Choice A reason:

Extra insulin is not typically required during exercise for children with type 1 diabetes. In fact, exercise can lower blood glucose levels, and administering extra insulin could increase the risk of hypoglycemia. It is important to monitor blood glucose levels before, during, and after exercise to adjust insulin doses as needed, but extra insulin is generally not necessary.

Choice B reason:

Exercise usually lowers blood glucose levels rather than increasing them1. Physical activity helps the body use glucose more efficiently, which can lead to a decrease in blood glucose levels. However, it is important to monitor blood glucose levels closely, as some high-intensity exercises can cause temporary increases in blood glucose due to the release of stress hormones.

Choice C reason:

Extra snacks are needed before exercise to prevent hypoglycemia in children with type 1 diabetes. Consuming a carbohydrate snack before physical activity helps maintain stable blood glucose levels during exercise. The amount of carbohydrates needed can vary based on the intensity and duration of the exercise, so it is important to monitor blood glucose levels and adjust snack intake accordingly.

Choice D reason:

Exercise should not be restricted for children with type 1 diabetes. Regular physical activity is important for overall health and can help improve insulin sensitivity, cardiovascular health, and overall well-being. With proper planning and monitoring, children with type 1 diabetes can safely participate in a wide range of physical activities.