The nurse is reinforcing education to the caregivers of a 9-year-old client diagnosed with scarlet fever. The client has a history of type 1 diabetes mellitus. Which statement by the caregivers indicates that further teaching is needed?

Question

The nurse is reinforcing education to the caregivers of a 9-year-old client diagnosed with scarlet fever.  The client has a history of type 1 diabetes mellitus.  Which statement by the caregivers indicates that further teaching is needed?

Quizplus · Accepted Answer

An acute illness (eg, scarlet fever) in clients with type 1 diabetes may trigger the release of stress hormones, which leads to higher blood glucose and ketone levels (sometimes leading to ketoacidosis). Clients with type 1 diabetes do not produce any insulin (unlike those with type 2 diabetes), so clients should not skip administration of external insulin even if not eating. Insulin therapy should be continued as prescribed during an acute illness (Option D). Additional sick-day management includes: Increasing frequency of blood glucose level checks (every 1-4 hours) Increasing or decreasing the dose of insulin as needed based on blood glucose levels Maintaining adequate hydration Testing for urinary ketones frequently (Options A and C) Stress hormones released during illness cause increased insulin resistance and lead the body to break down fat for energy. Ketones are produced when fat is broken down, which can lead to diabetic ketoacidosis (DKA). The client's urine should be monitored frequently for ketones while the client is sick. Fluids are encouraged to clear ketones from the system and prevent dehydration. (Option B) Blood glucose should be assessed frequently while the client is ill due to the potentially unpredictable and rapidly changing levels caused by illness and/or fasting. Educational objective: Clients with type 1 diabetes should not discontinue insulin usage during an illness. Encouraging fluids and monitoring glucose and ketone levels are priorities for this client.

The Nurse Is Reinforcing Education to the Caregivers of a 9-Year-Old