A nurse is caring for an adolescent who has been diagnosed with diabetic ketoacidosis (DKA). The nurse notes the following:

Exhibits

When planning care for this client, the nurse should anticipate a provider's prescription for which of the following?

Choice A reason: This is a contraindication for the MMR immunization, which is a live attenuated vaccine. A child who has a congenital immunodeficiency may not be able to mount an adequate immune response to the vaccine and may be at risk of developing the diseases from the vaccine.

Choice B reason: This is not a contraindication for the MMR immunization. A mild fever after a previous immunization is not a sign of an allergic reaction or a serious adverse effect. The child can still receive the MMR immunization as long as they do not have a moderate or severe illness.

Choice C reason: This is not a contraindication for the MMR immunization. Taking antibiotics for otitis media does not interfere with the effectiveness or safety of the vaccine. The child can still receive the MMR immunization as long as they do not have a moderate or severe illness.

Choice D reason: This is not a contraindication for the MMR immunization. A mild cough and a low-grade fever are not signs of a moderate or severe illness that would prevent the child from receiving the vaccine. The child can still receive the MMR immunization as long as they do not have any other contraindications.

Choice A reason: This is not a correct statement by the child. The child should take their regular insulin as prescribed, even when they are sick. Insulin helps the body use glucose for energy and prevents high blood sugar levels, which can cause complications. The child may need to adjust their insulin dose or frequency depending on their blood glucose levels, food intake, and activity level.

Choice B reason: This is not a correct statement by the child. The child should not store unopened bottles of insulin in the freezer. Freezing can damage the insulin and make it ineffective. The child should store unopened bottles of insulin in the refrigerator, away from direct light and heat. The child should store opened bottles of insulin at room temperature and discard them after 28 days.

Choice C reason: This is not a correct statement by the child. The child's morning blood glucose should be between 70 and 110 mg/dL, according to the American Diabetes Association. A blood glucose level between 90 and 130 mg/dL may indicate that the child has hyperglycemia, or high blood sugar, which can cause symptoms such as thirst, hunger, fatigue, and frequent urination.

Choice D reason: This is a correct statement by the child. The child should eat a snack half an hour before playing soccer or engaging in any physical activity. Physical activity lowers blood glucose levels, and a snack can help prevent hypoglycemia, or low blood sugar, which can cause symptoms such as shakiness, sweating, dizziness, and confusion.