Nurse Angelo admits a child with suspected type 1 DM; which should the nurse ask the parents?
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Solution
“Has the child experienced nocturia or bedwetting?”
D:Bedwetting in children who have previously stayed dry at night is often an early sign of diabetes. Type 1 diabetes is a disease when the pancreas that produces insulin and helps get sugars (glucose) into the cells does not produce insulin.
Which of the following should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin?
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Solution
Clean the site of injection with soap and water and avoid alcohol
D: Infection risk from insulin injections is negligible (at least in normal environments – some experts feel hospital environments are riskier), and an alcohol swab is a poor way to sanitize skin in the first place. Soap and hot water are actually more effective.
A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
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Solution
Systematically rotate injection sites
D: It is necessary to rotate injection sites because injecting in the same place much of the time can cause hard lumps or extra fat deposits to develop.
Nurse Dorothy is caring for a child with Cushing’s syndrome; which of the following should she include in the plan of care?
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Solution
Encourage a diet high in potassium
D: The elevation of cortisol level in Cushing’s disease causes a decrease in the level of potassium, a condition called hypokalemia. At high levels, cortisol stimulates the tubules that control the absorption of electrolytes in the kidneys to excrete more potassium into the urine.
Arvic who is diagnosed with diabetes mellitus type 1 displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents?
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Solution
Give the child honey (simple sugar).
A: Immediate action is important. Therefore, providing little sugar temporarily corrects low serum glucose levels. A simple sugar is preferred because it is converted to glucose more quickly than a complex sugar. A child with hyperglycemia needs fluid to prevent dehydration.
B: Because complex sugars, such as milk, are absorbed more slowly, they do not provide an immediate response.
C: Contacting the healthcare provider wastes valuable time during which emergency measures could be started to raise the child’s glucose level.
D: Prompt action is required to prevent complications of hypoglycemia.
Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares to the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?
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Solution
The child should be allowed to play because doing so can foster healthy self-esteem.
A: Engaging in peer-group activities can aid foster a sense of belonging and a positive self-concept. T-ball is a good sport to choose because physical stature is not an important consideration in the ability to participate, unlike some other sports, such as basketball and football.
B: Hypopituitarism does not affect calcium and phosphorus homeostasis and demineralization of bone. So the risk for fractures is not increased.
C: Although rare, physical activity without adequate carbohydrate intake can cause hypoglycemia.
D: Moderate physical activity increases caloric use and reduces weight without undue strain on weight-bearing joints.
Which type of diabetes mellitus (DM) most likely results from heterogenous risk factors, making it preventable?
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Solution
Type 2
B: Type 2 DM is a complex disorder of various causes with social, behavioral, and environmental risk factors. The disorder may be prevented by encouraging lifestyle modification for children at risk.
Tara is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can’t take a pill rather than shots like her grandmother does. Which of the following would be the nurse’s best reply?
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Solution
“Your body does not make insulin, so the insulin injections help to replace it.”
C: The child has type 1 DM, indicating a lack of functioning pancreatic beta cells and an absolute insulin deficiency.
A: Oral antidiabetics are indicated only for those with some functioning beta cells, as in those with type 2 DM. Therefore, injections are indicated to supply insulin that is lacking in type 1 diabetes.
B: Oral antidiabetics do not correct metabolism.
D: A child with type 1 DM cannot substitute an oral antidiabetic for insulin, regardless of age.
In growing children, growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following?
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Solution
Anterior pituitary gland hypofunction
A: Short stature usually results from diminished or deficient growth hormone, which is released from the anterior pituitary gland.
B: Posterior pituitary hyperfunction results in increased secretion of antidiuretic hormone or oxytocin, leading to a syndrome of inappropriate antidiuretic hormone secretion, marked by fluid retention and hyponatremia.
C: Parathyroid hypofunction leads to hypocalcemia
D: Thyroid hyperfunction causes increased secretion of thyroxine, triiodothyronine, and thyrocalcitonin, resulting in Graves’ disease, marked by accelerated linear growth and early epiphyseal closure.
Nurse Aries entered the room of a child with hypopituitarism and was asked by the couple about the condition of their child. Which of the following phrases if stated by the nurse best describes the condition?
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Solution
Linear growth retardation with skeletal proportions normal for chronologic age
A: Although linear growth retardation occurs in hypopituitarism, delayed epiphyseal maturation allows for normal skeletal proportions.
B: The child with hypopituitarism commonly experiences delayed sexual maturation.
C: Normal growth may occur for the first year, followed by linear growth thereafter.
D: Height is affected more profoundly than weight, contributing to obesity.