A 13-year-old Native American female has a body mass index (BMI) at the 90th percentile for age. The primary care pediatric nurse practitioner notes the presence of a hyperpigmented velvet-like rash in skin folds. The child denies polydipsia, polyphagia, and polyuria. The nurse practitioner will take what action?

Question

Quizplus · Accepted Answer

The presence of hyperpigmented velvet-like rash in skin folds is a clinical manifestation of insulin resistance, which is associated with type 2 diabetes. Therefore, a fasting blood sample for a metabolic screen is the most appropriate initial action to assess for potential type 2 diabetes in this patient. Counseling the child to lose weight may be appropriate, but further evaluation is necessary before making any lifestyle recommendations. A random glucose of 180 mg/dL alone is not adequate to diagnose diabetes. Referral to a pediatric endocrinologist may be necessary depending on the results of the metabolic screen.

A 13-Year-Old Native American Female Has a Body Mass Index