Question 1

What does the nurse instruct a 12-year-old to do when teaching how to administer insulin?

Accepted Answer

Children often find it easier to learn to inject the needle at a 90-degree angle.

Question 2

Although the child with type 1 diabetes had her prescribed insulin at 7:30 AM,the child is complaining of hunger and thirst and is drowsy at 10:30 AM.What should the nurse do first?

Accepted Answer

The immediate remedy is to give orange juice to raise the blood glucose.Giving more sugar will increase the blood glucose in a hyperglycemic child.Walking exercise will use up even more glucose.The treatment for hyperglycemia is to give the patient more insulin.

Question 3

The nurse is teaching the parents of a child with diabetes insipidus about water intoxication.The nurse would tell the parents to be alert for what symptom?

Accepted Answer

Signs of water intoxication include edema,lethargy,nausea,and central nervous system signs.

Question 4

On what understanding does the nurse plan the care of a child with a new diagnosis of type 1 diabetes mellitus?

Accepted Answer

Type 1 insulin-dependent diabetes mellitus is characterized by an absolute or complete deficiency of insulin.

Question 5

After a closed head injury,the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP).Based on these symptoms,what does the nurse suspect has developed?

Accepted Answer

Diabetes insipidus can be acquired as the result of a head injury or tumor,and suppression of the posterior pituitary causes copious urine output with an attendant drop in BP.The child can become dehydrated very quickly if some remedy is not applied.

Question 6

A child with diabetes is brought to the emergency department.He is flushed and drowsy,and his skin is dry.His father states that the child has been feeling progressively worse since the morning.What is this child most likely experiencing?

Accepted Answer

In ketoacidosis,the child's skin is dry,and the face is flushed.Patients appear dehydrated.They may perspire and be restless.The breath has a fruity odor,and there is no rest period between inspiration and expiration.

Question 7

What occurs as a result of an inadequate secretion of insulin?

Accepted Answer

When insulin is deficient,the body cannot metabolize carbohydrates for energy.The body is also unable to store and use fat properly.Incomplete fat metabolism produces ketone bodies that accumulate in the blood.

Question 8

Which statement made by a 7-year-old child with type 1 diabetes mellitus indicates a need for more teaching?

Accepted Answer

The child with type 1 diabetes mellitus has an insulin deficiency and will require lifelong management of this disease.Insulin does not cure the pancreas.

Question 9

What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia,diaphoresis,and headaches in the morning?

Accepted Answer

The Somogyi phenomenon (rebound hyperglycemia)occurs when the blood glucose level is lowered to the point at which the body's counter-regulatory hormones are released,producing the symptoms described.

Question 10

What is an important consideration for the school-age child taking DDAVP for diabetes insipidus?

Accepted Answer

The child with diabetes insipidus needs liberal access to bathrooms and water fountains.Arrangements may have to be made with the school to allow access.

Question 11

Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes mellitus?

Accepted Answer

The nutritional needs of a child with diabetes mellitus are essentially the same as those of the nondiabetic child,with the exception of the elimination of concentrated carbohydrates such as sugar.Fiber has been shown to reduce blood glucose levels.

Question 12

What statement by a parent leads the nurse to determine a parent is administering levothyroxine (Synthroid)correctly?

Accepted Answer

Synthroid should be given at the same time each day,preferably in the morning.

Question 13

Why does the nurse instruct an 11-year-old diabetic child to use the side of the finger for blood testing?

Accepted Answer

The sides of the finger have fewer nerve endings and more capillaries but are not easier to puncture than the fingertip.The risk for infection is remote for either site.

Question 14

A child receives a combination of regular and NPH insulin at 8:00 AM.At 8:45 AM the breakfast trays have not yet arrived from the kitchen.What is the best action by the nurse?

Accepted Answer

A child who receives regular insulin before meals may have an insulin reaction if food is not eaten within 20 minutes.A snack of graham crackers and milk will prevent an episode of hypoglycemia.

Question 15

A mother reports that her 4-month-old infant is lethargic,sleeps 18 hours a day,and snores.The nurse recognizes these signs are characteristic of what?

Accepted Answer

The infant with hypothyroidism will appear sluggish,and the tongue will be enlarged,causing noisy respiration.

Question 16

What would be the most appropriate nursing response to a woman who says,"My sister had a child with Tay-Sachs disease,and I want to know if I could have a child with this condition"?

Accepted Answer

Carriers can be identified by screening tests.Tay-Sachs disease has an autosomal recessive pattern of transmission.

Question 17

The parents of a child newly diagnosed with diabetes mellitus tell the nurse,"Our son's body is resistant to insulin." With what does the nurse recognize this description is consistent?

Accepted Answer

Type 2,non-insulin-dependent diabetes mellitus is caused by insulin resistance or failure of the body to use the insulin.

Question 18

Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise?

Accepted Answer

Blood glucose is high after meals.The child with type 1 diabetes mellitus who skips a meal before exercise is at risk for hypoglycemia.

Question 19

The nurse discussed treatment of hypoglycemia with an adolescent.Which statement by the adolescent leads the nurse to determine the patient understood the instructions?

Accepted Answer

The immediate treatment of hypoglycemia consists of administering sugar in some form such as orange juice,hard candy,or a commercial product.Cheese will eventually raise the blood glucose,but not as quickly as candy.

Question 20

A nurse is planning to teach a family about Tay-Sachs disease.What will the nurse relay about the pattern of inheritance for inborn errors of metabolism?

Accepted Answer

The pattern of inheritance is generally autosomal recessive.

Quiz 31: The Child With a Metabolic Condition