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","C","D"]
Explanation
Rationales:
A. Droplet precautions are typically used for infections transmitted through respiratory droplets, such as influenza or COVID-19. Since the symptoms described are more consistent with pyloric stenosis rather than an infectious disease, droplet precautions are not indicated.
B. The infant's symptoms are indicative of possible hypertrophic pyloric stenosis, a condition where the pylorus (the opening from the stomach to the small intestine) becomes narrowed, leading to forceful vomiting and dehydration. Surgical intervention, such as a pyloromyotomy, is often required to correct this condition.
C. The FLACC (Face, Legs, Activity, Cry, Consolability) scale is used to assess pain in infants and young children who cannot verbalize their discomfort. Given the infant's fussiness and symptoms, evaluating pain is crucial to managing the infant's discomfort.
D. Monitoring intake and output is important in an infant with vomiting to assess for dehydration and ensure appropriate fluid balance. This is a key aspect of managing any vomiting-related condition and ensuring the infant receives adequate hydration.
E. In the case of hypertrophic pyloric stenosis, thickened liquids are not recommended. The main treatment is surgical, and feeding modifications alone will not address the underlying condition.
F. A plain water enema is not appropriate for this infant’s symptoms. Hypertrophic pyloric stenosis does not require an enema and may actually worsen the infant's condition.
Correct Answer is A
Explanation
Rationale:
A. Circumcision is often delayed in newborns with hypospadias because the foreskin may be needed for the surgical repair of the urethra.
B. While surgery is necessary, it is not typically an emergency; it is planned and performed later in infancy.
C. In hypospadias, the urethral opening is located on the underside (ventral side) of the penis, not the top.
D. Undescended testicles (cryptorchidism) are a separate condition from hypospadias.