A charge nurse is teaching a newly licensed nurse about administering heparin to a client. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

A. Potassium chloride 10 mEq/hr:
While potassium replacement is crucial in DKA, initiating it before fluid resuscitation can lead to further complications. Insulin administration can drive potassium back into cells, potentially causing hypokalemia. Fluid resuscitation helps address dehydration and electrolyte imbalances.
B. Bicarbonate by IV infusion:

Bicarbonate therapy is generally reserved for severe cases of acidosis, and its use in DKA is controversial. In this scenario, the blood glucose level is not significantly elevated, and the focus should be on fluid resuscitation and insulin administration.
C. Subcutaneous insulin injections:
While insulin is a critical component of DKA management, it should be administered intravenously for faster and more precise control of blood glucose levels. Subcutaneous insulin injections are not the initial route of administration in DKA.
D. 0.9% sodium chloride 15 mL/kg/hr:
This is the correct answer. The first step in DKA management is fluid resuscitation with isotonic saline (0.9% sodium chloride). The goal is to address dehydration, restore intravascular volume, and improve perfusion. Insulin therapy and other interventions follow fluid resuscitation.

A. Rotate the application site every week (Correct Answer): This is the correct advice. Rotating the application site helps prevent skin irritation and enhances absorption. It's common practice to apply the patch to a different, clean, and hairless area of the skin each time it is changed.
B. The transdermal patch releases nicotine rapidly into the bloodstream: This statement is incorrect. The transdermal nicotine patch is designed to release nicotine gradually over an extended period. It provides a steady, controlled release of nicotine to help manage withdrawal symptoms and cravings.
C. Leave the patch in place for 8 hr each day: The specific duration for wearing a nicotine patch can vary depending on the product. However, it's generally recommended to wear the patch for 16 to 24 hours, depending on the product's instructions. Leaving it on for 8 hours only may not provide adequate coverage for the entire day.
D. The transdermal patch can cause insomnia: While insomnia is a potential side effect of nicotine replacement therapy, including the patch, it is not a universal experience for everyone. Insomnia is more likely to occur if the patch is worn continuously, including during the night. Following proper usage guidelines, such as removing the patch before bedtime, can help minimize this side effect.