43. A nurse is reinforcing teaching about use of a metered-dose inhaler (MDI) with a client who has a new diagnosis of asthma. Identify the sequence the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)

D. Obesity and weight loss are more directly linked to type 2 diabetes but they are not primary factors in the management of type 1 diabetes. Type 1 diabetes is characterized by the autoimmune destruction of beta cells, leading to an absolute deficiency of insulin. Weight loss can improve insulin sensitivity, which might be relevant for type 2 diabetes or insulin resistance, but type 1 diabetes patients will always require exogenous insulin regardless of weight changes.
A. Patients with type 1 diabetes are at risk for diabetic ketoacidosis (DKA), a serious condition caused by high blood glucose levels and ketone buildup due to insufficient insulin. Monitoring blood glucose levels is crucial in preventing DKA.
B. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin- producing beta cells in the pancreas. A viral infection can sometimes trigger this autoimmune response in genetically susceptible individuals.
C. There is a genetic component to type 1 diabetes, and having a family history of the disease can increase the risk, although environmental factors also play a role.

C. Good control of blood glucose levels and blood pressure is essential in reducing the risk of diabetic retinopathy and its progression. Research has shown that maintaining tight glycemic control and managing hypertension can significantly decrease the likelihood and severity of retinopathy in patients with diabetes.

A. Laser surgery is a treatment option for certain complications of diabetic retinopathy, such as retinal hemorrhage or retinal detachment. However, it's essential to emphasize that prevention through good glycemic control and regular eye exams is key to reducing the risk of these complications, rather than relying solely on surgical interventions after they occur.
B. Cataracts are more common in individuals with diabetes and can be surgically corrected but this statement does not directly address the concern about retinopathy. Cataracts and retinopathy are separate ocular complications of diabetes, each requiring different management strategies.
D. Diabetes remains one of the leading causes of blindness in the United States, primarily due to its association with diabetic retinopathy. While advancements in diabetes management and eye care have helped reduce the incidence of blindness, it is still a significant concern for individuals with diabetes.