Peds Evolve Quizzing Endocrine

A 15-year-old child has type 2 diabetes mellitus and needs dietary instruction from the nurse. Which statements from the nurse would provide the child with important information on nutritional needs? Select all that apply.

-"You should have enough calories for your energy, growth, and development." -"Food intake should correspond to the timing and action of the insulin prescribed." -"You should plan to incorporate snacks between meals and at bedtime."

A 7-year-old boy has been diagnosed with precocious puberty. What is the best explanation of the condition the nurse gives to the parents?

"It is sexual development in boys before the age of 9 years."

Which condition is the nurse alert for while providing care for an unconscious child with diabetes insipidus (DI)?

Dehydration

A school-age child recently diagnosed with type 1 diabetes mellitus asks the nurse if he can still play soccer, baseball, and swim. The nurse's response should be based on knowledge that:

exercise is not restricted unless indicated by other health conditions.

What instruction does the nurse provide to parents of a child with chronic adrenocortical insufficiency? Select all that apply.

-"Be alert for any signs of gastric problems." -"Manage the child's diet to prevent obesity." -"Keep extra supplies of medication at home." -"Do not frequently invite a lot of visitors."

Which instructions does the nurse give to the parents for safe and effective administration of insulin injection to the child with diabetes mellitus? Select all that apply.

-"Inject insulin in the fat tissue over muscle." -"Use the pinch technique for tenting the skin." -"Do not overuse one injection site." -"Avoid injecting on the exercising extremity."

A child with type 1 diabetes mellitus is prescribed NovoLog and Novolin N insulin twice daily. It is to be injected before breakfast and before the evening meal. What additional information should the nurse give the child? Select all that apply.

-"Insulin needs will change continuously during periods of growth and development." -"Your insulin needs will depend on your level of activity planned and your pubertal status." -"Your insulin needs will vary in spring and summer and during illness." -"You should administer 60% to 75% of the total daily dose before breakfast and the rest before the evening meal."

Arrange the steps in which the process of ketoacidosis occurs in patients with diabetes mellitus.

1. Insulin is absent in the body or insulin sensitivity is altered. 2. Glucose is unavailable for cellular metabolism. 3. The body chooses fats for cellular metabolism. 4. The liver converts glycerol in the fat cells to ketone bodies. 5. The excess ketone bodies are eliminated in the urine or the lungs. 6. The ketone bodies in the blood lower serum pH, producing ketoacidosis.

A teenager with type 1 diabetes mellitus is diagnosed with diabetic ketoacidosis (DKA). The child is conscious, and arterial oxygen is more than 80%. The child is not showing any signs of fever. In which order should the nurse perform the interventions to help such a patient?

1. The patient should be admitted immediately to an intensive care facility for management. 2. The child should be measured, weighed, and placed on a cardiac monitor after a 12-lead electrocardiogram is obtained. 3. Blood glucose and ketone levels, electrolytes, blood urea nitrogen (BUN), and creatinine should be taken. 4. The nurse should prime the tubing with the insulin mixture to saturate the insulin-binding sites before the infusion is started. 5. The nurse should obtain venous access for administration of fluids, electrolytes, and insulin and then administer it.

Which intervention does the nurse implement if steroid therapy causes cushingoid features in a child?

Administers the drug in the morning

The nurse suspects that the child has delayed growth. The nurse does not have serial height and weight records to assess the child's growth. What action does the nurse take?

Asks about the child's growth as compared to siblings.

Which is a priority nursing action after administering the prescribed dose of tapazole (Methimazole) to a child?

Assess for fever and sore throat.

A child with hypoparathyroidism is experiencing headaches and vomiting. The nurse also observes that the child has blurred vision. Which condition does the nurse suspect in the child?

Brain tumor

Which intervention does the nurse implement if a child with diabetes mellitus has decreased food intake due to flu?

Frequently monitor the blood glucose levels and urinary ketones.

Which information should the nurse include when teaching a patient about Cushing syndrome?

It is caused by excessive production of cortisol.

Which precaution does the nurse take when administering oral fluids to a child after the acute phase of adrenal crisis is over?

Plans a gradual schedule for administering fluids

What action does the nurse take when the child on insulin therapy suddenly begins to tremble and sweat?

Provide a glass of orange juice.

The nurse assigned to care for a child with type 1 diabetes mellitus and needs to determine the amount of morning regular insulin to administer. How should the nurse determine the dosage?

The dosage of morning regular insulin is determined by blood glucose patterns in the late morning and lunchtime blood glucose values.

Which is a priority action when a child with chronic renal disease is diagnosed with secondary hyperparathyroidism?

To raise the serum calcium levels

The nurse is explaining that the destruction of pancreatic β-cells is the cause of which disorder?

Type 1 diabetes

Which condition does the nurse assess for in a child who presents with manifestations of hyperthyroidism like hyperactivity and emotional lability?

Visual disturbances

The most important nursing consideration related to congenital hypothyroidism is:

early identification of the disorder.

The nurse is planning care for a child recently diagnosed with diabetes insipidus. The plan should include:

encouraging the child to wear medical identification.

Parents have brought their child in to the clinic for a well-child visit. They express some concern that the child seems to have short stature. The needs to determine if the cause is familial short stature or constitutional growth delay. What steps does the nurse take to evaluate the growth curve? Select all that apply.

-Determine the child's absolute height. -Assess the child's height velocity. -Determine the child's weight-to-height ratio.

The nurse caring for a 6-year-old child with diabetes mellitus notices that the child is sweating profusely. The child also complains of headache, dizziness, and shortness of breath. What should the nurse's immediate actions be? Select all that apply.

-Inform the primary health care provider. -Assess the child's blood glucose levels.

The nurse is teaching an adolescent (newly diagnosed with type I diabetes) ways to minimize discomfort with insulin injections. Which interventions are helpful in minimizing injection discomfort? Select all that apply.

-Do not reuse needles. -Remove all bubbles from the syringe before injection. -Do not move the direction of the needle-syringe during insertion or withdrawal.

The primary health care provider asks the nurse to monitor a child for signs of diabetes insipidus (DI). Which early signs does the nurse observe? Select all that apply.

-Enuresis -Excessive thirst -Polyuria

Which therapies are prescribed for a child after bilateral adrenalectomy? Select all that apply.

-Glucocorticoid therapy -Mineralocorticoid therapy

An infant with congenital adrenal hyperplasia (CAH) has increased pigmentation of the skin creases and ambiguous genitalia. Which other signs of adrenal insufficiency does the nurse assess? Select all that apply.

-Hyperkalemia -Hyponatremia -Weight gain

Which physical characteristics are seen in children with acromegaly? Select all that apply.

-Overgrowth of the head -Enlarged jaw -Increased facial hair -Deeply creased skin

Which tests confirm hypoparathyroidism in a child? Select all that apply.

-Parathyroid hormone (PTH) Test -Kidney function test -Magnesium test -Bone radiograph

Which interventions does the nurse implement to minimize heat intolerance in a child with hyperthyroidism? Select all that apply.

-Restricts physical activity -Provides cotton clothing -Provides frequent baths

The primary goals of the nurse caring for a child with illness and diabetic mellitus are to restore euglycemia, treat urinary ketones, and maintain hydration. What steps should the nurse take to provide effective care? Select all that apply.

-The nurse should monitor the glucose levels and urinary ketones every 3 hours and encourage intake of fluids. -The child's food intake and insulin dosage should be adjusted depending on glucose levels and degree of illness. -The health care provider should be notified if the child vomits or if blood glucose levels and urinary ketones rise.

The patient is diagnosed with diabetes insipidus. The health care provider has prescribed antidiuretic hormone (ADH) replacement with vasopressin tannate in peanut oil to help the patient get a full night's sleep. How should the nurse administer the medication? Select all that apply.

-Vasopressin should be resuspended in the oil by being held under warm running water for 10 to 15 minutes. -Vasopressin must be shaken vigorously before being drawn into the syringe and small brown particles should be observed.

The nurse is discharging a 10-year-old patient admitted to the hospital in diabetic ketoacidosis. The child has been newly diagnosed with type 1 diabetes mellitus (DM) on this admission. The nurse should teach the child and parents which signs of type 1? Select all that apply.

-nocturia -dry skin -blurred vision

Which instruction does the nurse give to the parents of a child with diabetes mellitus? Select all that apply.

-"Provide leafy green vegetables and mushrooms." -"Maintain consistency in the total number of calories every day." -"Avoid giving snacks between mealtimes." -"Provide extra food in case of increased activity."

The nurse is assessing a child with delayed growth. Which questions does the nurse include in the assessment while interviewing the parents? Select all that apply.

-"Tell me about diseases in your family." -"What kind of developmental issues did the child have?" -"Have there been changes in the child's appetite?" -"What kind of medications does the child take?"

The nurse plans to teach an adolescent diagnosed with type 1 diabetes about exercise and lifestyle changes that can help manage the diabetic condition. What information should the nurse include in the teaching plan? Select all that apply.

-"The type and duration of exercise should be planned around your interests and capabilities." -"You can have snacks before you exercise to compensate for decreasing blood glucose levels."

The nurse is working with an 11-year-old child who has type 1 diabetes mellitus. The nurse advises the child's parents to monitor the glucose levels at home. What should be the blood glucose levels if the diabetes mellitus is well managed? Select all that apply.

-A random blood glucose level that is consistently less than 200 mg/d -An 8-hour fasting blood glucose level that is regularly less than 126 mg/dL

An adolescent with type 1 diabetes is receiving regular insulin, Novolin R, and intermediate-acting insulin, Novolin N. The patient receives a combination of the two 30 minutes before breakfast and before the evening meal. At what time should the nurse anticipate a hypoglycemic reaction? Select all that apply.

-Before breakfast -Before supper or late afternoon

Which conditions can be seen in a child with hypopituitarism? Select all that apply.

-Delayed dentition -Delayed sexual development -Diminished height