Question 1

Which laboratory finding confirms that a child with type 1 diabetes is experiencing diabetic ketoacidosis?

Accepted Answer

The presence of diabetic ketoacidosis (DKA) is confirmed by a low arterial pH, typically below 7.3. Other common laboratory findings in DKA include elevated blood glucose, elevated serum ketones, and low serum bicarbonate. Choice A is incorrect because the presence of urinary ketones (rather than their absence) helps confirm DKA. Choices C and D are incorrect because elevated serum carbon dioxide and phosphorus are not specific laboratory findings in DKA.

Question 2

Which is the nurse's best response to the parents of a 10-year-old child newly diagnosed with type 1 diabetes mellitus who are concerned about the child's continued participation in soccer?

Accepted Answer

Giving the child an extra 15 to 30 g of carbohydrate snack before soccer practice can help prevent hypoglycemia during exercise. It is important to educate the child and coach on recognizing and treating hypoglycemia during sports activities. Restricting participation in sports can lead to social isolation and decreased physical activity, which can worsen the child's diabetes control. Alternative sports may not appeal to the child and may not be a feasible option. Encouraging intellectual activity is important, but physical activity is also important for overall health.

Question 3

Which nursing intervention is appropriate for a child with type 1 diabetes who is experiencing deficient fluid volume related to abnormal fluid losses through diuresis and emesis? Select all that apply.

Accepted Answer

Initiating IV access and providing IV fluid replacement with normal saline are appropriate interventions to address deficient fluid volume. D51/2NS is not the best choice as it contains too much glucose for a child with type 1 diabetes. Weighing the child on arrival and monitoring intake and output are also appropriate interventions.

Question 4

When would a child diagnosed with type 1 diabetes mellitus most likely demonstrate a decreased need for insulin?

Accepted Answer

The "honeymoon" phase occurs after the initial diagnosis of type 1 diabetes mellitus, during which the child's pancreatic beta cells may temporarily recover and produce some insulin on their own. As a result, the child may experience a decreased need for exogenous insulin during this period. However, this phase is usually temporary and insulin doses will need to be adjusted accordingly.

Question 5

Type 1 diabetes,the most common childhood endocrine disease,presents challenges to the nurse in the areas of teaching,management,and adherence.Due to recent changes in health care delivery systems,meeting the needs of a type 1 diabetic child has become even more complicated.Unless the newly diagnosed child is in diabetic ketoacidosis,the child may not be hospitalized.Is this statement true or false?

Accepted Answer

This statement is correct.Therefore the nurse must develop a plan of care that involves child and family education and supports them in either an inpatient or in outpatient setting.

Question 6

Which sign is the nurse most likely to assess in a child with hypoglycemia?

Accepted Answer

The nurse is most likely to assess irritability and serum glucose less than 60 mg/dL in a child with hypoglycemia. Option A shows urine positive for ketones (which is indicative of diabetic ketoacidosis, not hypoglycemia) and serum glucose greater than 300 mg/dL (which is indicative of hyperglycemia, not hypoglycemia). Option B shows normal sensorium (which is not indicative of hypoglycemia) and serum glucose greater than 160 mg/dL (which is indicative of hyperglycemia, not hypoglycemia). Option D shows increased urination (which is not indicative of hypoglycemia) and serum glucose less than 120 mg/dL (which is close to normal range and may not necessarily indicate hypoglycemia).

Question 7

Which children admitted to the pediatric unit would the nurse monitor closely for development of SIADH? Select all who apply.

Accepted Answer

Children with brain tumors, meningitis, and head trauma are at higher risk for developing SIADH due to potential damage or irritation to the brain, which can affect the regulation of antidiuretic hormone.

Question 8

Which comment by a 12-year-old child with type 1 diabetes indicates deficient knowledge?

Accepted Answer

There is currently no pill that can replace insulin for individuals with type 1 diabetes, so this statement indicates a lack of understanding.

Question 9

A child is diagnosed with hypothyroidism.The nurse should expect to assess which symptoms associated with hypothyroidism? Select all that apply.

Accepted Answer

A child with hypothyroidism will display fatigue,dry,thick skin,and cold intolerance.Weight loss and diarrhea are signs of hyperthyroidism.

Question 10

The rise in the incidence of both overweight and obese children is directly related to the increase in the number of children diagnosed with _______________.

Accepted Answer

The answer of The rise in the incidence of both...

Question 11

What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness?

Accepted Answer

It is important for the child to consume enough calories to prevent hypoglycemia, but if solid foods are not tolerable, substitutions such as simple carbohydrates or calorie-containing liquids can be used. The child should still receive their regular dose of insulin to prevent hyperglycemia. Encouraging fluids is also important to prevent dehydration. A visit to the emergency department is not necessary unless the child is experiencing severe symptoms or complications.

Quiz 51: The Child With an Endocrine or Metabolic Alteration