A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

Rationale: A. Check your urine for ketones when blood glucose levels are greater than 240 mg/dL: Monitoring for ketones when hyperglycemia occurs helps detect early diabetic ketoacidosis. Identifying ketones allows for timely medical intervention and prevents worsening acidosis and dehydration. B. Withhold your usual daily dose of insulin: Insulin should never be withheld during illness because the body typically needs more insulin to counteract stress hormones. Stopping insulin increases the risk of severe hyperglycemia and development of DKA. C. Test your blood glucose level every 8 hours: During illness, blood glucose levels can fluctuate rapidly, requiring monitoring every 2–4 hours. Testing only every 8 hours would delay recognition and treatment of dangerously high glucose levels. D. Drink 240 to 360 milliliters of calorie-free liquids every 8 hours: Fluid intake is important to prevent dehydration, but the recommended frequency is every hour rather than every 8 hours. Frequent fluids help maintain hydration and reduce ketone concentration in the urine.