A nurse is teaching a client who was recently diagnosed with type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

Rationale:

• "We should expect the swelling and tingling to worsen before it gets better." This statement needs reinforcement because worsening swelling and tingling can indicate early signs of compartment syndrome. These symptoms are not normal and should prompt immediate medical attention.

• "It is important that our child avoids placing anything inside the cast." This statement reflects understanding because inserting objects inside the cast can break the skin and introduce bacteria, leading to infection. It may also damage the padding and compromise skin protection.
• "We should prop the casted arm on pillows for the next 24 hours." Elevating the limb helps reduce swelling and pain by improving venous return. Keeping the casted arm elevated is a standard part of cast care teaching after an injury.
• "We should notify the provider if the cast becomes loose over time." A loose cast may no longer immobilize the fracture effectively and can allow excessive movement. It may also rub the skin, increasing the risk of irritation or breakdown.
• "We need to be very careful about how we handle the cast for the first 2 days while it dries." This shows understanding because a plaster cast takes 24 to 48 hours to fully dry. Improper handling can cause pressure indentations, leading to skin damage and poor cast integrity.

Rationale:

A. The client is drinking 2.5 L of water per day: Adequate hydration is important during pregnancy to support blood volume, amniotic fluid levels, and kidney function. A fluid intake of 2.5 liters per day is appropriate and does not raise concerns.

B. The client started working in a parking garage 3 months ago: Parking garages may expose individuals to carbon monoxide and other vehicle exhaust fumes, which can pose risks to fetal development. Prolonged exposure to poor air quality warrants further evaluation for potential harm.

C. The client last visited the dentist 4 months ago: Regular dental care is encouraged during pregnancy due to increased risk of gingivitis and periodontal disease. Visiting the dentist 4 months ago is within a normal range and does not signal unsafe behavior.

D. The client is doing 30 min of moderate exercise daily: Moderate exercise is recommended during pregnancy unless contraindicated. It improves circulation, mood, and energy, and supports healthy weight gain and fetal outcomes.