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 A
Explanation
Choice A rationale
Testing the urine for ketones is essential for managing type 1 diabetes, especially during illness. Ketones are produced when the body breaks down fat for energy due to insufficient insulin. High levels of ketones can lead to diabetic ketoacidosis, a serious condition that requires immediate medical attention.
Choice B rationale
While notifying the provider if blood glucose levels are over 350 mg/dL is important, it is not the most immediate action required during illness management. High blood glucose levels can indicate poor diabetes control, but ketone testing is more critical during illness to prevent ketoacidosis.
Choice C rationale
Withholding insulin when feeling nauseous is incorrect. Insulin should not be withheld during illness, as blood glucose levels can increase due to stress or infection. Continuing insulin administration is crucial to prevent hyperglycemia and ketoacidosis.
Choice D rationale
Limiting fluid intake during mealtime is not recommended. Proper hydration is essential for overall health and helps manage blood glucose levels. Fluids should be consumed as needed, especially during illness.
Correct Answer is C
Explanation
Choice A rationale
Placing the child on a no-salt-added diet is important for managing fluid retention and hypertension in acute glomerulonephritis, but it is not the immediate priority.
Choice B rationale
Educating the parents about potential complications is essential for long-term management, but it is not the immediate priority in an acute setting.
Choice C rationale
Checking the child’s daily weight is the priority action because it helps monitor fluid balance and detect any signs of fluid retention or worsening condition. Accurate daily weight measurements are crucial for assessing the effectiveness of treatment and making necessary adjustments.
Choice D rationale
Maintaining a saline-lock is important for intravenous access, but it is not the immediate priority compared to monitoring fluid balance through daily weight checks.