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 D
Explanation
Choice A rationale
Sitting on a nurse’s lap leaning forward is a position that can be used for postural drainage in infants with cystic fibrosis. This position helps drain secretions from the upper lobes of the lungs.
Choice B rationale
The supine position (lying on the back) is also used for postural drainage to target different areas of the lungs. It is not contraindicated for infants with cystic fibrosis.
Choice C rationale
Sitting on a nurse’s lap leaning backward is another position that can be used for postural drainage. This position helps drain secretions from the lower lobes of the lungs.
Choice D rationale
The Trendelenburg position (lying flat on the back with the feet elevated higher than the head) is contraindicated for infants with cystic fibrosis. This position can increase the risk of gastroesophageal reflux and aspiration, which can worsen respiratory symptoms.
Correct Answer is B
Explanation
Choice A rationale
Treating upper respiratory infections with over-the-counter medication is not recommended for children with sickle cell anemia. These children are at higher risk for infections and complications, and any signs of infection should be promptly evaluated by a healthcare provider.
Choice B rationale
Ensuring a consistent and daily intake of adequate fluids is crucial for preventing dehydration in children with sickle cell anemia. Dehydration can trigger a sickle cell crisis, leading to severe pain and other complications.
Choice C rationale
Avoiding immunizations is incorrect. Children with sickle cell anemia should receive all recommended vaccinations to prevent infections, which can be more severe in these children.
Choice D rationale
Suggesting that the child participate in sports activities without restriction is not advisable. Children with sickle cell anemia should avoid strenuous activities that can lead to dehydration and trigger a sickle cell crisis. .