A nurse is caring for four clients for whom she has to administer oral medications in the morning. The nurse should administer which of the following medications before breakfast?

A. Using a suppository for bowel movement is a common approach for managing bowel function in people with paralysis and is appropriate.

B. Carrying a water bottle to stay hydrated is important, especially since individuals with paralysis may be at increased risk of urinary tract infections. Adequate hydration is beneficial.

C. Doing wheelchair exercises while watching TV is a proactive way to maintain muscle tone and overall health, which is crucial for individuals with paralysis.

D. "I only need to catheterize myself twice every day!"

Explanation: In the context of spina bifida and paralysis from the waist down, catheterization is often required for bladder management. Individuals with this condition often experience urinary retention and require intermittent catheterization to empty their bladder. However, "twice every day" is not usually sufficient for someone with paraplegia. Adequate catheterization frequency is crucial to prevent urinary retention, infections, and other complications.

A) "I can store unopened bottles of insulin in the freezer."

This statement is incorrect. Insulin should not be stored in the freezer. Insulin should be stored in the refrigerator, and the currently used vial can be kept at room temperature for up to 28 days to avoid the discomfort of injecting cold insulin.

B) "I should not take my regular insulin when I am sick."

This statement is incorrect. When a person with type 1 diabetes is sick, it's important to continue taking insulin. In fact, during illness, blood sugar levels can become more difficult to manage, and insulin may be needed in adjusted doses. Skipping insulin during sickness can lead to uncontrolled blood sugar levels and potentially worsen the illness.

C) "My morning blood glucose should be between 90 and 130."

This statement is a good range to aim for in terms of fasting blood glucose levels, but it's not an indication of understanding the teaching about diabetes management as a whole. While this knowledge is important, the statement about eating a snack before playing soccer directly reflects understanding of how to manage blood sugar during physical activity.

"D) I should eat a snack half an hour before playing soccer."

Explanation:

Managing blood sugar levels is crucial for individuals with type 1 diabetes, especially when engaging in physical activities like playing soccer. Eating a snack before playing helps prevent hypoglycemia (low blood sugar) during exercise. Physical activity can cause the body to use up glucose faster, potentially leading to low blood sugar levels, and having a snack before exercise can help maintain stable blood sugar levels.