Which sign is the nurse most likely to assess in a child with hypoglycaemia?

Hypoglycaemia is characterized by low blood sugar levels. In children, symptoms of hypoglycaemia can vary, but irritability is a common sign. Other signs and symptoms of hypoglycaemia in children may include sweating, trembling, pale skin, hunger, weakness, confusion, and dizziness.

Normal sensorium and serum glucose greater than 160 mg/dL in (Option A) is incorrect because a normal sensorium (normal level of consciousness) and a serum glucose level greater than 160 mg/dL would not be indicative of hypoglycaemia.

Urine positive for ketones and serum glucose greater than 300 mg/dL in (Option B) is incorrect because it describes characteristics of hyperglycaemia (high blood sugar levels) rather than hypoglycaemia. Positive urine ketones and a serum glucose level greater than 300 mg/dL are commonly seen in diabetic ketoacidosis, a complication of high blood sugar levels in diabetes.

Increased urination and serum glucose less than 120 mg/dL in (Option D) is incorrect because it describes increased urination and a serum glucose level less than 120 mg/dL. While a serum glucose level less than 120 mg/dL could indicate hypoglycaemia, increased urination is not a typical sign of hypoglycaemia. Increased urination may be seen in conditions such as diabetes mellitus when blood sugar levels are consistently high.

Upper extremity fractures in children commonly occur as a result of falls. Children are more prone to falls due to their developing motor skills, balance, and coordination. They may fall from playground equipment, bicycles, or simply while running or playing.

While sports injuries (Option A) can also lead to upper extremity fractures, falls are generally the most common cause in children.

Physical abuse (Option B) is an unfortunate possibility in some cases, but it is important to approach the assessment without assuming abuse as the cause without appropriate evidence or disclosure.

Upper extremity fractures resulting from automobile crashes (Option D) are less common in children compared to falls or sports injuries, although they can occur in severe accidents.

It is always important for the nurse to assess the child's history, obtain a detailed account of the injury, and consider any additional signs or indications that may suggest non-accidental trauma if appropriate.