Deck 48: Nursing Care of a Family When a Child Has an Endocrine or a Metabolic Disorder

Question 1

The nurse is caring for a school-age child newly diagnosed with type 1 diabetes mellitus. Which nursing action supports the 2020 National Health Goals to reduce the long-term complications from this disease process?

A) Schedule the child and parents to attend diabetes education classes.
B) Explain how the child's physical abilities will be affected during school.
C) Recommend homeschooling so the mother can provide the needed medications.
D) Discuss admission to a rehabilitation facility to learn self-care with this disease process.

Answer 1

Schedule the child and parents to attend diabetes education classes.

Question 2

The nurse is planning care for a school-age child diagnosed with growth hormone deficiency. Which diagnosis should the nurse select to help the patient with this health problem?

A) Risk for situational low self-esteem related to short stature
B) Ineffective tissue perfusion related to infantile blood vessels
C) Impaired skin integrity related to overproduction of melanin
D) Risk for self-directed violence related to oversecretion of epinephrine

Answer 2

Risk for situational low self-esteem related to short stature

Question 3

The nurse is preparing teaching materials for a family whose child is prescribed somatropin (Humatrope) for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication?

A) This medication must be given by injection.
B) This medication must be given in the morning before school.
C) Hip or knee pain is an expected adverse effect of this medication.
D) This medication does not interact with any other types of medication.

Answer 3

This medication must be given by injection.

Question 4

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?

A) Vitamin K administration until school age
B) Administration of levothyroxine indefinitely
C) An increased intake of calcium beginning immediately
D) Administration of vitamin C until after growth is complete

Question 5

A new mother is concerned about the need to provide medication to a newborn every day for an indefinite period of time. What should the nurse encourage the mother to do to ensure medication compliance? (Select all that apply.)

A) Check the expiration dates on all medications.
B) Plan times for medications that fit in with the lifestyle.
C) Build medication administration into the general home routine.
D) Make medication administration pleasant such as including it during mealtimes.
E) Schedule prescription refills at least 1 day before the current amount is used up.

Question 6

A school-age girl is diagnosed as having Cushing syndrome from long-term therapy with oral prednisone. What assessment finding is consistent with this patient's diagnosis and treatment?

A) Child appears pale and fatigued.
B) There are purple striae on the abdomen.
C) The child is excessively tall for chronologic age.
D) The child is demonstrating signs of hypoglycemia.

Question 7

The nurse is planning care for a 12-year-old child diagnosed with hyperthyroidism. Which issue should the nurse anticipate that this child will experience while attending school?

A) Inability to fit legs under a school desk
B) Noncomprehension of written material
C) Increase in sleepiness by the end of the day
D) Inability to submit neat handwriting assignments

Question 8

A newborn female is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this patient?

A) Enlarged clitoris
B) Divergent vision
C) Small for gestational age
D) Abnormal facial features

Question 9

A mother, distressed to learn that her school-age child is diagnosed with type 2 diabetes mellitus, asks the nurse how this could happen because no one in the family has diabetes. What should the nurse explain to the mother?

A) "This is caused by the pancreas not making enough insulin."
B) "This disorder usually occurs when inadequate calories are ingested on a regular basis."
C) "Because this disorder is genetic, someone in the family will eventually develop the illness."
D) "This disorder is associated with overweight and eating a diet high in fats and carbohydrates."

Question 10

A newborn is diagnosed with the salt-losing form of congenital adrenogenital hyperplasia. On what should the nurse focus when assessing this patient?

A) Dehydration
B) Hypoglycemia
C) Bleeding tendency
D) Excessive cortisone secretion

Question 11

Shortly after delivery, a newborn is diagnosed with hypocalcemia. What manifestation will the nurse assess in this patient?

A) Jitteriness
B) Constipation
C) Excessive sleepiness
D) A distended abdomen

Question 12

The nurse is caring for a 3-year-old child diagnosed with phenylketonuria. Which food should the nurse remove before providing the child with a lunch tray?

A) Orange juice
B) Lettuce leaves
C) A sliced banana
D) Chocolate pudding

Question 13

The nurse is explaining to the parents of a school-age child with type 1 diabetes mellitus how the health care provider determines the daily insulin dose. The child is prescribed to receive 0.5 units/kg of body weight of intermediate-acting and short-acting insulin at the ratio of 2:1. Because the child weighs 66 lb, how many units of the short-acting insulin will the health care provider prescribe? (Enter numeric value only.)

Question 14

A mother caring for a school-age child with type 1 diabetes mellitus is frantic because the child self-administered 15 units of regular insulin instead of the prescribed 5 units before breakfast this morning. What should the nurse instruct the mother to do at this time? (Select all that apply.)

A) Observe for nervousness, weakness, dizziness, or sweating.
B) Determine if the child is experiencing extreme hunger and thirst.
C) Determine if the child is irritable or demonstrating stubbornness.
D) Provide the child with a half-glass of orange juice or regular soda.
E) Rub a small amount of honey on the child's gums and inside of the cheek.

Question 15

The nurse instructs a preadolescent child with type 1 diabetes mellitus how to
Self-administer an injection of short-acting and long-acting insulin. Which observation indicates to the nurse that teaching has been successful?

A) Administers the insulin intramuscularly
B) Wipes off the needle with an alcohol swab
C) Administers the insulin at a 30-degree angle
D) Draws up the short-acting insulin into the syringe first