A nurse is assessing a toddler who is toilet-trained and has a temperature of 38.5° C (101.3° F). Which of the following findings should the nurse recognize as an indication of a urinary tract infection (UTI)?

A. "Expect the medication to cause constipation for the first few days of therapy.": This statement is incorrect. Metformin commonly causes gastrointestinal side effects such as diarrhea, abdominal discomfort, and nausea, especially when therapy is initiated. Constipation is not typically associated with metformin use.

B. "Take the medication at the same time each day.": This is a correct instruction. It is important for the adolescent to take metformin at the same time each day to maintain consistent blood levels of the medication and optimize its effectiveness.

C. "This medication is used for short-term therapy until your symptoms improve.": This statement is incorrect. Metformin is typically used for long-term management of type 2 diabetes mellitus to help control blood sugar levels. It is not intended for short-term therapy.

D. "Take this medication 1 hour before meals.": This statement is incorrect. While metformin can be taken with meals to reduce gastrointestinal side effects, it is not necessary to take it specifically 1 hour before meals. It can be taken with meals or shortly after meals.

A. Decreased calories:

During illness, it's important to ensure adequate calorie intake to meet the body's increased energy demands for fighting off infection. Decreasing calories is not appropriate and can lead to hypoglycemia in a child with diabetes mellitus.

B. Increased fluids:

This is the correct option. During illness, the body's fluid requirements increase due to fever, sweating, and increased urination. Providing increased fluids helps prevent dehydration, which can exacerbate hyperglycemia. Parents should encourage the child to drink plenty of water or other sugar-free fluids to stay hydrated.

C. Blood glucose monitoring every 8 hr:

During illness, blood glucose levels may fluctuate more than usual due to changes in food intake, activity level, and the body's response to stress. Therefore, more frequent blood glucose monitoring is necessary, typically every 2-4 hours or as directed by the healthcare provider, rather than every 8 hours.

D. Urine testing for leukocytes:

Urine testing for leukocytes is not directly related to managing diabetes mellitus during illness. It may be done to assess for urinary tract infections, which can occur more frequently in individuals with diabetes, but it is not a routine part of diabetes management during illness.