Chapter 31 - The child with a metabolic condition

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

Type 2, noninsulin-dependent diabetes mellitus

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

There is an absolute deficiency of insulin

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

They are usually autosomal recessive.

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?

"A screening test can be done to determine if you are a carrier of the gene."

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

"I give the medication at 8:00 AM every day."

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

Focus on complex carbohydrates and eat foods high in fiber

The nurse explained that the diagnosis of diabetes is made with the fasting blood glucose is _______ mg/dL on two separate occasions, and the history is positive for indication of the disease.

126

The nurse assessing a glycosylated hemoglobin (Hba1c) test is aware that this test can evaluate average glucose level over a period of _____ to _____ months.

3; 4

The nurse remind the parents of a diabetic with an insulin pump that the tubing of the pump should be changed aseptically every _______ hours

48

When discussing possible causes a diabetes and children the nurse mentions chromosomal defects. Which chromosomes are associated with diabetes? Select all that apply

6 7 12 20

A child with diabetes mellitus is observed to have cold symptoms. What signs and symptoms will alert parents of the possibility of ketoacidosis? Select all that apply

Fruity breath Nausea

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

Give her a cup of orange juice

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

Give the patient a snack of graham crackers and milk

The nurse is preparing to administer a long acting insulin. Which insulin is considered a long acting?

Glargine

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

Arrange for the child to use the bathroom when needed

Which laboratory result indicates good metabolic control for a child with type 1 diabetes mellitus?

Glycosylated hemoglobin value of 8%

What does the nurse remind the adolescent with diabetes that soluble fiber in the diet can reduce? Select all the apply

Blood glucose Serum cholesterol Absorption of sugar Insulin requirements

What makes keeping diabetes in control in an adolescent difficult? (Select all that apply.)

Hormonal changes Developmental conflicts Preference for fast food Growth spurts

Long acting types of insulin are seldom given to children because of the danger of __________ during sleep.

Hypoglycemia

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

Hypothyroidism

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

Increased fat breakdown leads o ketonemia

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

It has fewer nerve endings.

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 the child most likely experiencing?

Ketoacidosis

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

Lethargy

Which process does the nurse explain the endocrine system is primarily responsible for controlling? Select all that apply

Maturation Reproduction Stress response Growth

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

My pancreas is sick and needs insulin until it is well.

What is the function of an insulin pump?

Provides continuous infusion of insulin

Which food sources are high in soluble fiber? Select all that apply

Raw fruits Beans Bran cereal

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

Sometimes I skip my breakfast when I have a game in the morning

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

Somogyi phenomenon

The home health nurse is monitoring an 8 month old child with hypothyroidism taking levothyroxine (synthroid). Which symptoms does the nurse recognize as a sign of overdose? Select all that apply

Tachycardia Irritability Diaphoresis

The nurse is disgusting insulin shock with parents of a child recently diagnosed with diabetes mellitus. What will the nurse respond when the parents ask why children are more prone to insulin reactions? Select all that apply

The condition is more unstable in children The activities are irregular They are still growing.

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

When my blood glucose is low or if I begin to feel hungry and weak I will eat six Lifesavers

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?

diabetes insipidus

What does the nurse instructed 12 real to do when teaching how to administer insulin?

inject the needle a 90-degree angle