A nurse is teaching a client about skin cancer prevention. Which of the following statements by the client indicates an understanding of the teaching?

Rationale:

A. 0.45% saline: This is a hypotonic solution and is typically used after initial fluid resuscitation, not as the first continuous infusion.

B. Glargine insulin: Glargine is a long-acting insulin given subcutaneously and is not appropriate for continuous IV infusion. In DKA, rapid insulin action is necessary to reduce blood glucose and suppress ketogenesis quickly.

C. 0.9% normal saline: The priority in managing Diabetic ketoacidosis is rapid fluid resuscitation due to severe dehydration. The nurse should initiate a continuous infusion of 0.9% normal saline (isotonic solution) first to restore circulating volume and improve perfusion. After initial stabilization, fluids may later be switched to 0.45% saline depending on sodium levels.D. NPH insulin: NPH is an intermediate-acting insulin used for long-term glycemic control, not for acute management of DKA. It is given subcutaneously and has a delayed onset, making it unsuitable for continuous IV infusion.

Rationale:

A. Set up the sterile field 5 cm (2 in) below waist level: Sterile fields must be at or above waist level to maintain sterility. Anything below the waist is considered contaminated because it is out of the nurse’s visual field and control.

B. Place the cap from the solution sterile side up on a clean surface: The inside of the cap must face up to avoid contamination. Placing it on a clean surface with the sterile side up preserves sterility for recapping the solution if needed.

C. Open the outermost flap of the sterile kit toward the body: The first flap should be opened away from the body to prevent reaching over the sterile field, which increases the risk of contamination.

D. Place the sterile dressing within 1.25 cm (0.5 in) of the ledge of the sterile field: Items must be placed at least 2.5 cm (1 in) from the edge of the sterile field. The outer 1 inch is considered non-sterile and any item placed within this margin is no longer sterile.