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 B
Explanation
Choice A rationale
Applying a cool pack to the heel prior to the procedure is not recommended as it can constrict blood vessels and make it more difficult to obtain a blood sample.
Choice B rationale
Puncturing the outer aspect of the heel is the correct technique for collecting a capillary blood specimen from an infant. This area has fewer nerve endings and is less likely to cause pain or injury.
Choice C rationale
Using a surgical blade to obtain the specimen is not appropriate for a capillary blood draw. A lancet should be used instead to make a small puncture in the skin.
Choice D rationale
Wiping the site with alcohol after the puncture is not recommended as it can cause irritation and discomfort. The site should be cleaned with alcohol before the puncture and then covered with a sterile gauze pad after the procedure.
Correct Answer is D
Explanation
Choice A rationale
Odorless urine is not a specific indicator of effective treatment for acute poststreptococcal glomerulonephritis (APSGN)16.
Choice B rationale
A temperature of 37.2°C (99°F) is within the normal range and does not specifically indicate effective treatment for APSGN16.
Choice C rationale
No report of pain with voiding is not a specific indicator of effective treatment for APSGN16.
Choice D rationale
Clear urine indicates that the hematuria (blood in urine) has resolved, which is a sign of effective treatment for APSGN1617.