C HAPTER 10: D IABETES M ELLITUS T YPE 1
1. Which sign is the nurse most likely to assess in a child with hypoglycemia?
a. Urine positive for ketones and serum glucose greater than 300 mg/dL
b. Normal sensorium and serum glucose greater than 160 mg/dL
c. Irritability and serum glucose less than 70 mg/dL
d. Increased urination and serum glucose less than 120 mg/dL
ANS: C
Irritability and serum glucose less than 70 mg/dL are neuroglycopenic
manifestations of hypoglycemia. Serum glucose greater than 300 mg/dL and
urine positive for ketones are indicative of diabetic ketoacidosis. Normal
sensorium and serum glucose greater than 160 mg/dL are associa ted with
hyperglycemia. Increased urination is an indicator of hyperglycemia. A serum
glucose level less than 120 mg/dL is within normal limits.
2. When would a child diagnosed with insulin-dependent diabetes mellitus most
likely demonstrate a decreased need for insulin?
a. During the honeymoon phase
b. During adolescence
c. During growth spurts
d. During minor illnesses
ANS: A
During the honeymoon phase, which may last from a few weeks to a year or
longer, the child is likely to need less insulin. During adolescence, physical
growth and hormonal changes contribute to an increase in insulin
, requirements. Insulin requirements are typically increased during growth
spurts. Stress either from illness or from events in the environment can cause
hyperglycemia. Insulin requirements are increased during periods of minor
illness.
3. What should a nurse suggest to the parent of a child with insulin -dependent
diabetes mellitus (IDDM) who is not eating as a result of a minor illness?
a. Give the child half his regular morning dose of insulin.
b. Substitute calorie-containing liquids for solid food to maintain normal
serum glucose levels.
c. Give the child plenty of unsweetened, clear liquids to prevent dehydration.
d. Take the child directly to the emergency department.
ANS: B
Calorie-containing liquids will maintain normal serum glucose levels and
decrease the risk of hypoglycemia. The child should receive his regular dose
of insulin even if he does not have an appetite. If the child is not eating as
usual, he needs calories to prevent hypoglycemia. During periods of minor
illness, the child with IDDM can be managed safely at home.
4. Which is the nurses best response to the parents of a 10 -year-old child newly
diagnosed with insulin-dependent diabetes mellitus (IDDM) who are concerned
about the childs continued participation in soccer?
a. Consider the swim team as an alternative to soccer.
b. Encourage intellectual activity rather than participation in sports.
c. It is okay to play sports such as soccer when the weather is moderate.
d. Give the child an extra 15 to 30 grams of carbohydrate snack before soccer
practice.
1. Which sign is the nurse most likely to assess in a child with hypoglycemia?
a. Urine positive for ketones and serum glucose greater than 300 mg/dL
b. Normal sensorium and serum glucose greater than 160 mg/dL
c. Irritability and serum glucose less than 70 mg/dL
d. Increased urination and serum glucose less than 120 mg/dL
ANS: C
Irritability and serum glucose less than 70 mg/dL are neuroglycopenic
manifestations of hypoglycemia. Serum glucose greater than 300 mg/dL and
urine positive for ketones are indicative of diabetic ketoacidosis. Normal
sensorium and serum glucose greater than 160 mg/dL are associa ted with
hyperglycemia. Increased urination is an indicator of hyperglycemia. A serum
glucose level less than 120 mg/dL is within normal limits.
2. When would a child diagnosed with insulin-dependent diabetes mellitus most
likely demonstrate a decreased need for insulin?
a. During the honeymoon phase
b. During adolescence
c. During growth spurts
d. During minor illnesses
ANS: A
During the honeymoon phase, which may last from a few weeks to a year or
longer, the child is likely to need less insulin. During adolescence, physical
growth and hormonal changes contribute to an increase in insulin
, requirements. Insulin requirements are typically increased during growth
spurts. Stress either from illness or from events in the environment can cause
hyperglycemia. Insulin requirements are increased during periods of minor
illness.
3. What should a nurse suggest to the parent of a child with insulin -dependent
diabetes mellitus (IDDM) who is not eating as a result of a minor illness?
a. Give the child half his regular morning dose of insulin.
b. Substitute calorie-containing liquids for solid food to maintain normal
serum glucose levels.
c. Give the child plenty of unsweetened, clear liquids to prevent dehydration.
d. Take the child directly to the emergency department.
ANS: B
Calorie-containing liquids will maintain normal serum glucose levels and
decrease the risk of hypoglycemia. The child should receive his regular dose
of insulin even if he does not have an appetite. If the child is not eating as
usual, he needs calories to prevent hypoglycemia. During periods of minor
illness, the child with IDDM can be managed safely at home.
4. Which is the nurses best response to the parents of a 10 -year-old child newly
diagnosed with insulin-dependent diabetes mellitus (IDDM) who are concerned
about the childs continued participation in soccer?
a. Consider the swim team as an alternative to soccer.
b. Encourage intellectual activity rather than participation in sports.
c. It is okay to play sports such as soccer when the weather is moderate.
d. Give the child an extra 15 to 30 grams of carbohydrate snack before soccer
practice.
