A nurse is providing teaching to a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teaching?
“I should not take my regular insulin when I am sick.”.
“I can store unopened bottles of insulin in the freezer.”.
“My morning blood glucose should be between 90 and 130.”.
“I should eat a snack half an hour before playing soccer.”.
The Correct Answer is C
Choice A rationale
Regular insulin should not be withheld during illness. When a person with type 1 diabetes is sick, their body may produce more glucose due to stress and infection, leading to hyperglycemia. Therefore, it is crucial to continue taking insulin to manage blood glucose levels effectively.
Choice B rationale
Insulin should not be stored in the freezer. Freezing insulin can cause it to degrade and lose its effectiveness. Insulin should be stored in the refrigerator at a temperature between 2°C and 8°C (36°F and 46°F) until it is opened. Once opened, it can be kept at room temperature for a specified period, usually around 28 days.
Choice C rationale
The target range for morning blood glucose levels in children with type 1 diabetes is typically between 90 and 130 mg/dL. Maintaining blood glucose within this range helps to prevent both hyperglycemia and hypoglycemia, ensuring better overall diabetes management and reducing the risk of complications.
Choice D rationale
Eating a snack before physical activity is important for children with type 1 diabetes to prevent hypoglycemia. Physical activity can lower blood glucose levels, so having a snack that contains carbohydrates can help maintain stable blood glucose levels during exercise.
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Correct Answer is B
Explanation
Choice A rationale
Insulin should be administered subcutaneously, not intramuscularly. Rotating sites is important to prevent lipodystrophy, but the correct technique involves subcutaneous injection.
Choice B rationale
Drawing up the short-acting insulin into the syringe first is correct. This prevents contamination of the short-acting insulin vial with long-acting insulin, ensuring accurate dosing.
Choice C rationale
Wiping off the needle with an alcohol swab is not recommended. The needle should remain sterile, and only the top of the insulin vial should be wiped with an alcohol swab.
Choice D rationale
Administering insulin at a 30-degree angle is incorrect. Insulin should be administered at a 90- degree angle if the person can grasp 2 inches of skin, or at a 45-degree angle if only 1 inch of skin can be grasped.
Correct Answer is D
Explanation
Choice A rationale
Taking pancreatic enzymes following meals is not effective. The enzymes need to be taken with meals to aid in the digestion of food as it is being consumed.
Choice B rationale
Pancreatic enzymes are not taken to improve metabolism. They are specifically prescribed to aid in the digestion of fats, proteins, and carbohydrates in children with cystic fibrosis.
Choice C rationale
Taking pancreatic enzymes 2 hours before meals is not effective. The enzymes need to be taken with meals to ensure they are present in the digestive tract when food is being digested.
Choice D rationale
Taking pancreatic enzymes helps digest the fat in foods. Children with cystic fibrosis have difficulty digesting fats due to the thick mucus that blocks the pancreatic ducts, preventing the release of digestive enzymes