Page 946 - Saunders Comprehensive Review For NCLEX-RN

8. Fruity odor to breath
9. Dehydration
10. Blurred vision
11. Slow wound healing
12. Changes in level of consciousness
C. Long-term effects
1. Failure to grow at a normal rate
2. Delayed maturation
3. Recurrent infections
4. Neuropathy
5. Cardiovascular disease
6. Retinal microvascular disease
7. Renal microvascular disease
D. Complications
1. Hypoglycemia
2. Hyperglycemia
3. Diabetic ketoacidosis
4. Coma
5. Hypokalemia
6. Hyperkalemia
7. Microvascular changes
8. Cardiovascular changes

For a child with diabetes mellitus, plan to initiate a consultation

with the diabetic specialist to plan the child’s care.
E. Diet

1. Normal healthy nutrition is encouraged, and the total
number of calories is individualized based on the
child’s age and growth expectations. For type 2
diabetes, the American Diabetes Association
recommendations can be found at
http://main.diabetes.org/dorg/PDFs/Type-2-Diabetes-
in-Youth/Type-2-Diabetes-in-Youth_14-18.pdf.
2. As prescribed by the PHCP, children with diabetes
need no special types of foods or supplements. They
need sufficient calories to balance daily expenditure
for energy and to satisfy the requirement for growth
and development.
3. Dietary intake should include 3 well-balanced meals
per day, eaten at regular intervals, plus a mid-
afternoon snack and a bedtime snack; a consistent
intake of the prescribed protein, fats, and
carbohydrates at each meal and snack is needed
(concentrated sweets are discouraged; fat is reduced
to 30% or less of the total caloric requirement).

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