When teaching a school-age child and the parent how to administer insulin, which of the following instructions should the nurse include?

Correct Answer: C

Rationale: It is essential to give insulin at room temperature to prevent discomfort during administration. Cold insulin can cause stinging and pain, which can be avoided by allowing the insulin to reach room temperature before administration. Storing insulin in the refrigerator is correct for long-term storage, but it should be brought to room temperature before use. Rotating injection sites is important to prevent lipohypertrophy, a condition characterized by fatty lumps that can develop if injections are consistently given in the same area. Administering insulin within 30 minutes of a meal is generally recommended to match the insulin peak action with the peak glucose levels after eating, but giving insulin at room temperature is more crucial to ensure comfort and proper absorption.

Correct Answer: C

Rationale: In assessing a child for Kawasaki disease, the correct finding to expect is a fever unresponsive to antipyretics (Option C). Kawasaki disease is characterized by persistent fever lasting more than 5 days, often unresponsive to typical fever-reducing medications. This fever is a hallmark sign of the disease and is crucial for early identification and treatment. Option A, decreased heart rate, is incorrect because Kawasaki disease is associated with tachycardia due to inflammation of the heart and blood vessels. Option B, dry, scaly skin, is incorrect as Kawasaki disease primarily affects the mucous membranes, leading to symptoms like red, cracked lips and a "strawberry" tongue. Option D, nontender cervical lymphadenopathy, is also incorrect as Kawasaki disease is typically associated with tender, enlarged lymph nodes. Educational context: Understanding the key clinical manifestations of Kawasaki disease is vital for pediatric nurses to promptly recognize and intervene in this potentially serious condition. Identifying the characteristic signs and symptoms, such as persistent fever, mucous membrane changes, and lymphadenopathy, is crucial for early diagnosis and appropriate management to prevent complications like coronary artery aneurysms.

Correct Answer: D

Rationale: The correct answer is D: Brush the child's teeth after administration. When teaching a parent about administering ferrous sulfate tablets to their child, it is essential to emphasize the importance of brushing the child's teeth after giving the medication. Ferrous sulfate can cause teeth staining, so brushing immediately after administration helps prevent this side effect. Option A: Giving the medication with milk is not recommended as it can decrease the absorption of iron from the ferrous sulfate tablets due to the calcium in milk binding to the iron. Option B: Taking the medication on an empty stomach is a common instruction for some medications to enhance absorption, but in the case of ferrous sulfate, it is better tolerated with food to reduce the risk of gastrointestinal upset. Option C: Avoiding giving the medication with orange juice is important because vitamin C in orange juice can enhance iron absorption, potentially increasing the risk of iron toxicity if not monitored closely. In a pediatric nursing context, educating parents about medication administration is crucial for ensuring proper treatment and minimizing side effects. Emphasizing specific instructions like brushing after giving ferrous sulfate tablets helps parents feel confident in caring for their child's health.

Correct Answer: B

Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.

Correct Answer: C

Rationale: The correct answer is C) "I will rotate injection sites each time I give my child insulin." This statement indicates an understanding of the teaching because rotating injection sites helps prevent lipodystrophy, a condition where fatty tissue under the skin becomes lumpy or hollow due to repeated injections in the same area. By rotating sites, insulin absorption remains consistent, leading to better glucose control. Option A is incorrect because while notifying the school is important, it does not specifically address diabetes management at home. Option B is incorrect as giving a carbohydrate snack for low blood glucose is a good practice, but it doesn't demonstrate an understanding of insulin administration. Option D is incorrect as the flu vaccine is essential for children with diabetes, but it doesn't directly relate to insulin administration. In a pediatric nursing context, teaching parents about insulin administration is crucial for managing type 1 diabetes in children. Understanding proper injection techniques and site rotation can prevent complications and ensure effective treatment. Parents play a vital role in their child's diabetes care, and empowering them with correct information is key to successful management.