A nurse is providing teaching to a school-age client who has a new diagnosis of type 1 diabetes mellitus. Which statement by the client indicates an understanding of the teaching?
"I will reduce my insulin dose if I am sick."
"I will eat a snack half an hour before playing soccer."
"I will count the amount of fat calories I consume to manage my diabetes."
"I will check my blood glucose level after meals."
The Correct Answer is B
Rationale:
A. Insulin doses should not be reduced when sick, as illness often increases blood glucose levels.
B. Eating a snack before physical activity helps prevent hypoglycemia, demonstrating a good understanding of how to manage blood glucose levels during exercise.
C. Counting carbohydrates, not fat calories, is essential for managing blood glucose levels in diabetes.
D. Blood glucose levels are typically checked before meals and at other key times, rather than only after meals.
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Correct Answer is B
Explanation
Rationale:
A. A PEFR of 45% of the personal best indicates a moderate asthma exacerbation, but immediate hospitalization is not necessarily required unless there are severe symptoms or other indicators of serious distress.
B. At 45% of the personal best PEFR, the child is experiencing a moderate asthma exacerbation. The recommended action is to use a quick-relief inhaler like albuterol, which is effective in providing immediate relief. Inhaled corticosteroids are part of the long-term management but should not replace the use of a quick-relief inhaler during an exacerbation.
C. Salmeterol is a long-acting beta-agonist used for maintenance therapy and is not typically used for acute exacerbations. Albuterol is preferred in this situation for immediate relief.
D. While monitoring PEFR is important, action should be taken when PEFR falls below 50% of the personal best, and more immediate intervention is needed at 45% of the personal best.
Correct Answer is D
Explanation
Rationale:
A. Thyroid storm is related to hyperthyroidism and is not directly associated with vasopressin treatment.
B. Vitamin D toxicity is unrelated to vasopressin and is not a concern in this scenario.
C. Cushing syndrome is caused by excess cortisol and is not related to vasopressin therapy.
D. SIADH is characterized by excessive release of antidiuretic hormone, which can lead to water retention and hyponatremia. Since vasopressin is an antidiuretic hormone analog, it can cause similar effects if not carefully monitored.