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
A 13% weight loss indicates severe dehydration. Dehydration is classified based on the percentage of body weight lost, with severe dehydration being more than 10%6.
Choice B rationale
A bulging anterior fontanel is a sign of increased intracranial pressure, not dehydration. In dehydration, the fontanel is typically sunken due to fluid loss.
Choice C rationale
Bradypnea, or slow breathing, is not a common sign of dehydration. Dehydration often leads to tachypnea, or rapid breathing, as the body tries to compensate for fluid loss.
Choice D rationale
A capillary refill time of 3 seconds is within normal limits. In severe dehydration, capillary refill time is usually prolonged, indicating poor perfusion.
Correct Answer is C
Explanation
Choice A rationale
Distended neck veins are not a typical manifestation of pyloric stenosis. This condition primarily affects the gastrointestinal system, leading to symptoms related to feeding and digestion rather than cardiovascular symptoms like distended neck veins.
Choice B rationale
Red currant jelly stools are associated with intussusception, not pyloric stenosis. Intussusception involves the telescoping of one part of the intestine into another, leading to obstruction and the characteristic stool appearance.
Choice C rationale
Projectile vomiting is a hallmark symptom of pyloric stenosis. This occurs due to the obstruction at the pylorus, which prevents food from passing into the small intestine, leading to forceful expulsion of stomach contents.
Choice D rationale
A ridged abdomen is not a typical symptom of pyloric stenosis. While the abdomen may be distended due to the obstruction, the primary symptom is projectile vomiting.