A nurse is assessing a 7-year-old child who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
Increased capillary refill.
Decreased appetite.
Thirst.
Shakiness.
The Correct Answer is D
Choice A rationale
Increased capillary refill time is not typically associated with hypoglycemia. It may indicate poor peripheral circulation but is not a common sign of low blood sugar levels.
Choice B rationale
Decreased appetite is not typically associated with hypoglycemia. Hypoglycemia usually causes symptoms such as shakiness, sweating, and confusion.
Choice C rationale
Thirst is not typically associated with hypoglycemia. It is more commonly a symptom of hyperglycemia (high blood sugar levels).
Choice D rationale
Shakiness or tremors are common signs of hypoglycemia. When blood sugar levels drop, the body responds by releasing adrenaline, which can cause shakiness.
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Correct Answer is A
Explanation
Choice A rationale
Prednisone is a corticosteroid that suppresses the immune system, making the child more susceptible to infections. Therefore, monitoring for signs of infection is crucial.
Choice B rationale
Prednisone can cause potassium loss, so limiting potassium-rich foods is not recommended. Instead, maintaining a balanced diet is important.
Choice C rationale
Prednisone does not stimulate growth spurts. In fact, long-term use can potentially stunt growth in children.
Choice D rationale
Discontinuing prednisone abruptly can cause adrenal insufficiency. If gastrointestinal upset occurs, the medication should be taken with food or the dosage adjusted, but not discontinued without consulting a healthcare provider.
Correct Answer is A
Explanation
Choice A rationale
Providing a doll for the 3-year-old child to imitate parental behaviors helps the child understand and adjust to the new role of being an older sibling. It allows the child to practice nurturing behaviors and can reduce feelings of jealousy or displacement by involving them in the care of the newborn.
Choice B rationale
Preparing the child for a change in all of their routines can be overwhelming and may cause unnecessary stress. It is more effective to maintain as much consistency as possible in the child’s routine while gradually introducing changes related to the new sibling.
Choice C rationale
Telling the child that they will now have a new playmate may create unrealistic expectations. A newborn is not immediately capable of playing, and this statement may lead to disappointment and frustration for the 3-year-old.
Choice D rationale
Waiting for the newborn to come home before moving the 3-year-old from the crib to a bed can create a sense of displacement and jealousy. It is better to make this transition well before the newborn’s arrival to allow the older child to adjust to the change independently of the new sibling.