Peds Exam 4: Chapters 26, 29, & 30
You are going over insulin administration education with a patient's mother. Which statement by her raises concern? A. "When she is sick I will hold her insulin." B."I always carry sugary items in case she has a hypoglemic attack." C. "I will bring her in every 3 months for a glycosylate hemoglobin blood drawn." D. "I ordered her a Medic-Alert bracelet yesterday."
A. When a diabetic is sick, they should never hold their insulin. This is because when the body is stressed or has an infection they are at a very high risk for hyperglycemia so it is essential they monitor their blood glucose closely and administered insulin as needed. All the other options are correct.
As the nurse, taking care of the patient who has been hospitalized for 3 days with dehydration, what abnormal finding would you report to the MD? A. Weight change of 100 lbs to 92 lbs and urinary output of less than 1 ml/kg/hr B. 1-3 second skin turgor C. Weight change of 90 lbs to 93 lbs and dry mucous membranes D. Options A & C
A. The only correct option is: Weight change of 100 lbs to 92 lbs and urinary output of less than 1 ml/kg/hr. All the other answers are normal findings that do not cause concern.
Substance known to disrupt normal hormone-related growth and development of children include all the following except: A. Aloin B. Dioxins C. Oral contraceptives D. Coumestans derived from alfalfa
A. Aloin Aloin is the one of the active compounds found in aloe vera gel, and has not been found to affect childhood growth and development. Dioxins are toxic byproducts of industrial processes. Oral contraceptives contain female sex hormones that can alter normal sexual development in children based on their time of exposure. Coumestans, while natural compounds found in some plants, are considered phytoestrogens, which have been shown to affect endocrine function.
The nurse knows that diabetic teaching has been effective when parents of a newly diagnosed child state they will, during an illness, prove the child with: A. more insulin B. more calories C. less insulin D. less protein
A. more insulin Illness causes greater insulin resistance, so more is needed to achieve normal blood glucose levels. Increased calorie intake will be ineffective without more insulin to assist the body with metabolizing those calories. Restricting protein is not recommended, but during illness, fluids and light carbohydrates are usually tolerated best.
6. A school-age client diagnosed with nephrotic syndrome is severely edematous. The primary healthcare provider has placed the child on bed rest. Which nursing intervention is a priority for this client? 1. Reposition the child every two hours. 2. Monitor BP every 30 minutes. 3. Encourage fluids. 4. Limit visitors.
Answer: 1 Rationale 1: A child with severe edema, on bed rest, is at risk for altered skin integrity. To prevent skin breakdown, the child should be repositioned every two hours. Vital signs are taken every four hours, fluids need to be monitored and should not be encouraged, and the child needs social interaction, so visitors should not be limited.
The nurse in the newborn nursery is performing the admission assessment on a neonate. Which assessment finding indicates the neonate may have congenital hip dysplasia? 1. Asymmetry of the gluteal and thigh fat folds 2. Trendelenburg sign 3. Telescoping of the affected limb 4. Lordosis
Answer: 1 Rationale 1: A sign of congenital hip dysplasia in the infant would be asymmetry of the gluteal and thigh fat folds. Trendelenburg sign and telescoping of the affected limb are signs that present in an older child with congenital hip dysplasia. Lordosis does not occur with hip dysplasia.
10. A child, in renal failure, is diagnosed with hyperkalemia. Which food choices will the nurse teach the parents and child to avoid? 1. Carrots and green, leafy vegetables 2. Chips, cold cuts, and canned foods 3. Spaghetti and meat sauce, breadsticks 4. Hamburger on a bun, cherry gelatin
Answer: 1 Rationale 1: Carrots and green, leafy vegetables are high in potassium. Chips, cold cuts, and canned foods are high in sodium but not necessarily potassium. Spaghetti and meat sauce with breadsticks and a hamburger on a bun with cherry gelatin would be acceptable choices for a low-potassium diet.
1. The nurse is providing care to a male infant who is diagnosed with hypospadias. Which clinical manifestation does the nurse anticipate when assessing this infant? 1. A urethral meatus that is located on the ventral surface of the penis 2. The presence of foreskin 3. A small opening or a fissure that extends the entire length of the penis 4. An opening on the dorsal surface of the penis
Answer: 1 Rationale 1: For an infant diagnosed with hypospadias, the nurse would anticipate a urethral meatus that is located on the ventral surface of the penis. Infants diagnosed with hypospadias may also have a partial absence of the foreskin. A small opening or a fissure that extends the entire length of the penis or an opening on the dorsal side of the penis would be expected for an infant diagnosed with epispadias.
The school nurse is providing care to a school-age client who experienced a sprain of the right ankle on the playground. Which intervention is appropriate for the nurse to implement for this client? 1. Apply ice to the extremity 2. Apply a warm, moist pack to the extremity 3. Perform passive range of motion to the extremity 4. Lower the extremity to below the level of the heart
Answer: 1 Rationale 1: For the first 24 hours of a sprain, rest, ice, compression, and elevation should be used. Therefore, the nurse should apply ice to the extremity.
13. A child is scheduled for a kidney transplant. The nurse completes the preoperative teaching to prepare the child and parents for the surgery and postoperative considerations. Which statement by the parents indicates understanding of the teaching session? 1. "We know it's important to see that our child takes prescribed medications after the transplant." 2. "We'll be glad we won't have to bring our child in to see the doctor again." 3. "We're happy our child won't have to take any more medicine after the transplant." 4. "We understand our child won't be at risk anymore for catching colds from other children at school."
Answer: 1 Rationale 1: It is important that the nurse emphasize compliance with treatments that will need to be followed after the transplant. Follow-up appointments will be necessary, as well as medications and general health promotion.
An adolescent client who is diagnosed with Duchenne muscular dystrophy is seen in the clinic for a routine health visit. Which nursing diagnosis is the priority for this client? 1. Risk for Impaired Mobility Related to Hypertrophy of Muscles 2. Risk for Infection Related to Altered Immune System 3. Risk for Impaired Skin Integrity Related to Paresthesia 4. Risk for Altered Comfort Related to Effects of the Illness
Answer: 1 Rationale 1: Nursing care for muscular dystrophy (MD) focuses on promoting independence and mobility for this progressive, incapacitating disease. Risk for Infection, Risk for Impaired Skin Integrity, and Risk for Altered Comfort are not as high a priority as Risk for Impaired Mobility.
7. A preschool-age client diagnosed with with nephrotic syndrome is placed on prednisone for several weeks. Which teaching point is appropriate for the nurse to include in the teaching plan for this client? 1. Never stop the medication suddenly. 2. This drug is taken once a week on Sunday. 3. The child should always take the medication at night before bed. 4. This drug should be taken with meals.
Answer: 1 Rationale 1: Prednisone, a corticosteroid with anti-inflammatory action, is frequently used to treat nephrotic syndrome. It should never be stopped suddenly. The drug is taken more than once a week and can be taken any time during the day, but should remain on a constant schedule. Taking with food is always appropriate for most medications, but it does not have to be with a meal.
The nurse completes parent education related to treatment for a pediatric client with congenital clubfoot. Which statement by the parents indicates the need for further education? 1. "We're happy this is the only cast our baby will need." 2. "We'll watch for any swelling of the feet while the casts are on." 3. "We'll keep the casts dry." 4. "We're getting a special car seat to accommodate the casts."
Answer: 1 Rationale 1: Serial casting is the treatment of choice for congenital clubfoot. The cast is changed every one to two weeks. Parents should be watching for swelling while the casts are on, keeping the casts dry, and using a car seat to accommodate the casts.
An adolescent client must wear a brace for the correction of scoliosis. Which nursing diagnosis is most appropriate for this client? 1. Risk for Impaired Skin Integrity 2. Risk for Altered Growth and Development 3. Risk for Impaired Mobility 4. Risk for Impaired Gas Exchange
Answer: 1 Rationale 1: The skin should be monitored for breakdown in any area the brace may rub. The other diagnoses would not be a priority and should be corrected by the wearing of the brace.
The nurse has completed discharge teaching for the family of a child diagnosed with Legg-Calve-Perthes disease. Which statement by the family indicates the need for further education? 1. "We're glad this will only take about six weeks to correct." 2. "We understand swimming is a good sport for Legg-Calve-Perthes." 3. "We know to watch for areas on the skin the brace may rub." 4. "We understand that abduction of the affected leg is important."
Answer: 1 Rationale 1: The treatment generally takes approximately two years. Swimming is a good activity to increase mobility. A brace may be worn, so skin irritation should be monitored. The leg should be kept in the abducted position.
The nurse is providing care to a toddler client who is diagnosed with osteogenesis imperfect. Which nursing intervention is appropriate for this client? 1. Support of the trunk and extremities when moving 2. Traction care 3. Cast care 4. Postop spinal surgery care
Answer: 1 Rationale 1: With osteogenesis imperfecta, nursing care focuses on preventing fractures. Because the bones are fragile, the entire body must be supported when the child is moved. Traction, casts, and spinal surgery are not routinely done for osteogenesis.
12. A child is prescribed hemodialysis for the treatment of kidney failure. When providing care for this child, what will the nurse monitor for during the assessment? (Select all that apply.) 1. Shock 2. Hypotension 3. Infections 4. Migraines 5. Fluid overload
Answer: 1,2,3 Rationale 1: Rapid changes in fluid and electrolyte balance during hemodialysis may lead to shock and hypotension. Other complications to watch for are thromboses and infection. Migraines and fluid overload are not clinical manifestations associated with hemodialysis.
A school health nurse is screening school-age students for scoliosis. Which assessment findings indicate the need for further evaluation for scoliosis? (Select all that apply.) 1. Uneven shoulders and hips 2. A one-sided rib hump 3. Prominent scapula 4. Lordosis 5. Pain
Answer: 1,2,3 Rationale 1: The classic signs of scoliosis include uneven shoulders and hips, a one-sided rib hump, and prominent scapula. Lordosis and pain are not present with scoliosis.
16. The nurse is preparing an educational session for sexually active adolescents. Which statements are appropriate for the nurse to include when educating about sexually transmitted infections (STIs)? (Select all that apply.) 1. "Frequently diagnosed STIs include chlamydia, genital herpes, gonorrhea, human papillomavirus, trichomoniasis, and syphilis." 2. "Your risk for contracting an STI can be decreased by using a condom when having sex." 3. "Birth control pills are useful in decreasing your risk of contracting an STI." 4. "Risk factors for pelvic inflammatory disease (PID) include multiple sexual partners, lack of barrier protection during intercourse, and history of an STI.' 5. "Pelvic inflammatory disease (PID) is an infection of the lower genital tract."
Answer: 1,2,4 Rationale 1: It is appropriate for the nurse to include the frequently diagnosed STIs, the fact that the risk is decreased by using a condom, and the risk factors for pelvic inflammatory disease. Birth control pills are useful in decreasing the risk of pregnancy but are not useful for decreasing the risk of contracting an STI. PID is an infection of the upper genital tract, not the lower genital tract.
9. A child diagnosed with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which action by the nurse is the most appropriate? 1. Check the urine to see if hematuria has increased. 2. Obtain a blood pressure on the child; notify the healthcare provider. 3. Reassure the child, and encourage bed rest until the headache improves. 4. Obtain serum electrolytes, and send a urinalysis to the lab.
Answer: 2 Rationale 1: Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. A blood pressure (BP) should be obtained and the healthcare provider notified. The healthcare provider may decide to order an antihypertensive to bring down the BP. This is a serious complication, and delay in treatment could mean lethargy and seizures. Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes) do not directly address the potential problem of encephalopathy.
11. A child recently had a kidney transplant and is prescribed cyclosporine. The parents ask the nurse about the reason for the cyclosporine. Which reason will the nurse include in the response for why this medication is prescribed? 1. To boost immunity 2. To suppress rejection 3. To decrease pain 4. To improve circulation
Answer: 2 Rationale 1: Cyclosporine is given to suppress rejection. It doesn't boost immunity, decrease pain, or improve circulation.
14. The nurse teaches parents that the anticholinergic drug oxybutynin is used to treat enuresis. The parents ask the nurse why the medication is being prescribed. Which response by the nurse is the most appropriate? 1. "It's an antidepressant that is used to help the child relax." 2. "It will help decrease the spasms sometimes associated with enuresis." 3. "It has an antidiuretic effect, so your child can attend sleepovers." 4. "It will slow the production of urine, so your child does not have to urinate as frequently."
Answer: 2 Rationale 1: Oxybutynin (Ditropan) is an anticholinergic that relaxes the smooth muscle of the bladder and decreases spasms. Oxybutynin is not an antidepressant or an antidiuretic, and does not slow urine production.
2. A nurse is preparing to admit a child with possible obstructive uropathy. Which laboratory test should the nurse expect to draw on this child? 1. Platelet count 2. Blood urea nitrogen (BUN) and creatinine 3. Partial thromboplastin time (PTT) 4. Blood culture
Answer: 2 Rationale 1: The blood urea nitrogen (BUN) and creatinine are serum lab tests for kidney function. Obstructive uropathy is a structural or functional abnormality of the urinary system that interferes with urine flow and results in urine backflow into the kidneys; therefore, the BUN and creatinine will be elevated. Platelet count and partial thromboplastin time (PTT) are drawn when a bleeding disorder is suspected. A blood culture is done when an infectious process is suspected.
8. A preschool-age client is diagnosed with acute glomerulonephritis and is admitted to the hospital. Which nursing diagnosis is most appropriate for this client? 1. Risk for Injury Related to Loss of Blood in Urine 2. Fluid-Volume Excess Related to Decreased Plasma Filtration 3. Risk for Infection Related to Hypertension 4. Altered Growth and Development Related to a Chronic Disease
Answer: 2 Rationale 1: The fluid is excessive, and fluid and electrolyte balance should be monitored. There is no risk for injury because the blood loss in the urine is not such that it causes anemia. While a risk for infection may be present, it is not related to the hypertension. Growth and development is not normally affected because this is an acute process, not a chronic one.
An infant returns from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which action by the nurse is the most appropriate? 1. Call the healthcare provider to report the edema. 2. Elevate the legs on pillows. 3. Apply a warm, moist pack to the feet. 4. Encourage movement of toes.
Answer: 2 Rationale 1: The legs should be elevated on a pillow for 24 hours to promote healing and help with venous return. Some amount of swelling can be expected, so it would not be appropriate to notify the healthcare provider, especially if the color, sensitivity, and movement remain normal to the toes. Ice should be applied, not heat. An infant would not be able to follow directions to move toes, and in this case it would not be as effective as elevating the legs on pillows.
The nurse is caring for a pediatric client in Bryant skin traction. Which nursing intervention is most appropriate for this client? 1. Remove the adhesive traction straps daily to prevent skin breakdown. 2. Check the traction frequently to ensure that proper alignment is maintained. 3. Place the child in a prone position to maintain good alignment. 4. Move the child as infrequently as possible to maintain traction.
Answer: 2 Rationale 1: The traction apparatus should be checked frequently to ensure that proper alignment is maintained. The adhesive straps should not be removed. The child should be placed in a supine position, and frequent repositioning is necessary to prevent complications of immobility.
A nurse is assessing a child after an open reduction of a fractured femur. Which assessment findings would indicate that the child is experiencing compartment syndrome? (Select all that apply.) 1. Pink, warm extremity 2. Pain not relieved by pain medication 3. Dorsalis pedis pulse present 4. Prolonged capillary-refill time with paresthesia 5. Skin appears tense.
Answer: 2,4,5 Rationale 1: The major serious complication post-fracture reduction is compartment syndrome. A prolonged capillary-refill time with loss of paresthesia, pain not relieved by medication, and skin that appears tense are signs of compartment syndrome. Pink, warm extremity; pain relieved by medication; and a present dorsalis pedis pulse would all be normal findings post-fracture reduction.
A nurse notes blue sclerae during a newborn assessment. Which item will the newborn require further assessment for based on this finding? 1. Marfan syndrome 2. Achondroplasia 3. Osteogenesis imperfecta 4. Muscular dystrophy
Answer: 3 Rationale 1: Clinical manifestations of osteogenesis imperfecta include blue sclerae. This is not present in Marfan syndrome, achondroplasia, or muscular dystrophy.
5. A child is admitted to the hospital unit with a diagnosis of minimal-change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment? 1. Hematuria, bacteriuria, weight gain 2. Gross hematuria, albuminuria, fever 3. Massive proteinuria, hypoalbuminemia, edema 4. Hypertension, weight loss, proteinuria
Answer: 3 Rationale 1: Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema. While hematuria and hypertension may be present, they are not pronounced. Gross hematuria and hypertension are associated with glomerulonephritis. Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.
3. The nurse is preparing to discharge a toddler-age client who just had an orchiopexy. Which discharge instruction is appropriate for this client? 1. Information to the parents about the child's resuming normal vigorous activities 2. Discussion with the parents about the low incidence of testicular malignancy and no further need for any follow-up 3. Explanation to the parents about the need for loose, nonrestrictive clothing 4. Reassurance to the parents that infertility is not a future risk
Answer: 3 Rationale 1: Orchiopexy is the surgical correction of cryptorchidism (failure of the testes to descend into the scrotal sac). Discharge instructions should include information about the need for loose, nonrestrictive clothing to avoid pressure on the postoperative site. The risk of testicular cancer is 35 to 50 times greater in men with a history of cryptorchidism. Long-term planning includes teaching the child to perform monthly testicular examinations once puberty has been reached. Vigorous activities such as straddling toys, riding bicycles, or rough play should be avoided for up to two weeks following surgery to promote healing and prevent injury. A discussion of fertility and the possible need for fertility testing is important, since cryptorchidism increases the risk of infertility.
The nurse is teaching family members how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip. Which statement will the nurse include in the teaching session? 1. "Apply lotion or powder to minimize skin irritation." 2. "Put clothing over the harness for maximum effectiveness of the device." 3. "Check at least two or three times a day for red areas under the straps." 4. "Place a diaper over the harness, preferably using a thin, superabsorbent, disposable diaper."
Answer: 3 Rationale 1: The brace should be checked two or three times for red areas under the straps. Lotion or powder can contribute to skin breakdown. A light layer of clothing should be under the brace, not over. The diaper should also be under the brace.
4. Which symptoms are characteristic of a preschool-age client who is diagnosed with a urinary tract infection? 1. Foul-smelling urine, elevated blood pressure, and hematuria 2. Severe flank pain, nausea, headache 3. Headache, hematuria, vertigo 4. Urgency, dysuria, fever
Answer: 4 Rationale 1: Clinical manifestations of a urinary tract infection (UTI) in a preschool-age client include fever, urgency, and dysuria. While hematuria may be present, there is no elevated blood pressure, headache, or vertigo.
A school-age client is admitted to the hospital with osteomyelitis. Which statement regarding the treatment of osteomyelitis is most appropriate for the nurse to share with the parents? 1. "Cultures should be done immediately after the first dose of antibiotic infuses." 2. "Antibiotics are ineffective against this virus." 3. "Methicillin is the antibiotic of choice." 4. "Antibiotic therapy should continue for 3-6 weeks."
Answer: 4 Rationale 1: Medical management of osteomyelitis begins with intravenous administration of a broad-spectrum antibiotic. Antibiotic therapy should continue for 3-6 weeks. Cultures are always done before an antibiotic is started. Methicillin is not the drug of choice.
A child returns from spinal-fusion surgery. Which item is the priority assessment for this child? 1. Increased intracranial pressure 2. Seizure activity 3. Impaired pupillary response during neurological checks 4. Impaired color, sensitivity, and movement to lower extremities
Answer: 4 Rationale 1: When the spinal column is manipulated, there is a risk for impaired color, sensitivity, and movement to lower extremities. The other signs are neurological impairment and are not high risk with spinal surgery.
15. The nurse educator is teaching a group of nursing students the pathophysiologic reasons related to genitourinary (GU) disorders in the pediatric population. Which statements are appropriate for the nurse educator to include in the teaching session (Select all that apply.) 1. "Incomplete organ development during fetal development is the cause of many GU disorders." 2. "Improper placement of the urethra in vagina is one cause of GU disorders." 3. "GU disorders in the pediatric population can be caused by hydronephrosis." 4. "GU disorders in the pediatric population are not caused by infections." 5. "Anatomic obstruction or incomplete nerve innervation can cause GU disorders."
Answers: 1,3,5 Rationale 1: Pathophysiologic causes of GU disorders in the pediatric population include incomplete organ development during fetal development; hydronephrosis; and anatomic obstruction or incomplete nerve innervations. Improper placement of the urethra in the penis, not the vagina, is another pathophysiologic cause of GU disorders. GU disorders can also be caused by infection.
A 5 year old a has temperature of 103.6 'F and is brought into the emergency room by his mother. Which statement by the mother causes concern? A. "I've tried to encourage fluid intake every hour." B. "I administered Aspirin to help with the fever a few hours ago." C. "I re-took his temperature 30 minutes after I gave the medication and it was still high." D. "I gave him a sponge bath to help with the fever."
B. A child should never have aspirin, especially for a fever due to Reyes Syndrome.
A 7 year old has been having vomiting with diarrhea for 3 days. How do you expect the child to present clinically? A. Sunken eyeballs and bradycardia B. None of the options are correct. C. Bradycardia, dry mucous membranes, absence of tears D. Tachycardia, dry mucous membranes, weight loss
B. The child should be experiencing dehydration and would present clinically with: Tachycardia, dry mucous membranes, weight loss, sunken eyes and/or fontanles, decreased urinary output
A student with type I diabetes mellitus complains of feeling lightheaded. Her blood sugar is 60 mg/dL. Using the 15/15 rule, the nurse should: A. give 15 mL of juice, and repeat does in 15 minutes B. give 15 grams of carbohydrates and retest blood sugar in 15 minutes C. Give 15 grams of carbohydrates and 15 g of protein D. Give 15 ounces of juice and retest blood sugar in 15 minutes
B. give 15 grams of carbohydrates and retest blood sugar in 15 minutes 15/15 rule states to give 15 g of carbohydrates (approx 60 calories; roughly 4 oz of juice or a tablespoon of honey or sugar). Protein by itself will treat hypoglycemia. Only 15 mL of juice does not contain enough calories to increase the blood sugar. Fifteen oz of juice nearly 4 times the recommended amount
A mother brings her child in the office for a follow-up appointment and voices concern that her child has started urinating more than normal and is constantly thirsty & hungry. As the RN, you suspect?* A. Hypoglyemia B. Phenylkentonuria C. Diabetes Mellitus D. Tret's syndrome
C. The symptoms the mother is reports are the classic 3 P's of diabetes: polyuria, polydipsia, polyphagia
During teaching, the nurse should advise the family of a child newly-diagnosed with Graves' disease to: A. Encourage outdoor activities B. Limit bathing to prevent skin irritation C. Promote interaction with one friend instead of a group D. Set the thermostat higher than normal for comfort
C. Promote interaction with one friend instead of a group Children with Graves' disease (an autoimmune conditions that causes hyperthyriodism) tend to be more emotionally labile, and may have difficulty managing group dynamics. Sweating and feeling too warm are common complaints; showering should be encouraged. Bright light, such as sunshine, may be irritating because of disease-related ophthalmopathy.
A patient with a history is diabetes is exhibiting sweating and slurred speech. What do you suspect is the cause? A. hyponaterima B. hypernaterima C.hyperglycemia D. hypoglycemia
D These are the classic symptoms of hypoglycemia.
A child is ordered by the doctor for ketone and glucose urine testing. The patient is to collect it at home. How would you instruct the patient to collect the specimen?* A. Cleanse the area with betadine. B. Encourage the patient to consume at least 24 oz of water prior to the specimen collection. C. Demonstrate a clean catch techinque. D. Use the second voided urine for most accurate results.
D. The patient should use the second voided urine to ensure that the results are accurate. First voided urines tend to be concentrated and could effect results.
A 15 year old, who is type 1 diabetic, reports that she almost "passes out" during gym class. What information would you assess from the teenager?* A. None of the options are correct. B. What type of form she needs to have filled out so she can be excused from gym class. C. How she takes her blood glucose after exercise. D. Her eating habits prior to gym class.
D. It is very important to ask the teen when and what she eats before gym. Type 1 diabetics are encouraged to eat before physical activity to decrease the chances of hypoglycemia (which is what this teen is experiencing). She should take her blood glucose BEFORE exercise not AFTER. There is no need for her to be excused from gym class because exercise is essential for diabetics.
An adolescent with Addison's disease may need an increased dosage of glucocorticoids to which of the following situations? A. completing spring semester of school B. Gaining 7 pounds C. Death of a family member D. Undergoing a root canal
D. Undergoing a root canal Physical stress, such as infection, surgery, dental work and pregnancy, can lead to adrenal crisis in those with Addison's disease. Psychological stress has less effect than physical stress. Adrenal insufficiency leads to weight loss.
A two-year-old has been admitted with a diagnosis of Kawasaki disease. Which of the following would be a priority on the plan of care for this child? A. vital signs every 6 hours B. Hourly intake and output records C. Skin care D. Passive range-of-motion exercises
Those with Kawasaki disease are at high-risk for CHF in the initial stages. Vital signs would need to be recorded more often than every 6 hours. Skin care and ROM exercises are important, but not the priority at this time.