A nurse is teaching a school-age child who has type 1 diabetes mellitus and his parents about illness management. Which of the following instructions should the nurse include?

A. During illness or when blood glucose levels are elevated, children with type 1 diabetes are at risk for diabetic ketoacidosis (DKA). Testing urine for ketones helps detect early signs of DKA so that timely intervention can occur. This is an essential component of sick-day management for pediatric patients. B. While very high blood glucose levels require attention, standard sick-day management often involves adjusting insulin and fluids before contacting the provider, unless persistent hyperglycemia or ketones are present. The threshold is usually lower for immediate notification depending on the provider’s instructions. C. Insulin should never be withheld, even if the child is ill or not eating well. Illness can increase blood glucose levels, so insulin doses may need adjustment but should not be skipped, as this increases the risk of DKA. D. Illness management for children with diabetes emphasizes adequate hydration to prevent dehydration and help manage hyperglycemia and ketone buildup. Limiting fluids is unsafe.