The nurse is providing education to a school-aged child recently diagnosed with type 1 diabetes mellitus (DM). Which item will the nurse include in the teaching plan regarding sick day management?

A. Insulin should never be skipped during illness. In fact, insulin needs may increase during sick days due to stress and elevated blood glucose levels. Holding insulin can lead to hyperglycemia and diabetic ketoacidosis (DKA). B. During illness, especially when the child has fever, vomiting, or hyperglycemia, strenuous exercise is not recommended because it can worsen dehydration and stress the body. Light activity may be acceptable if the child feels well, but exercise is not a priority during sick day management. C. During illness, blood glucose can fluctuate significantly. Monitoring only every 12 hours is insufficient. Blood glucose should be checked frequently (every 3–4 hours or more as needed) to guide insulin dosing and prevent complications. D. Sick days increase the risk of DKA, especially if blood glucose is elevated. The nurse should teach the child and family to monitor urine for ketones after each void or check blood ketones if available. Early detection of ketones allows prompt intervention, such as adjusting insulin, increasing fluid intake, and seeking medical care if necessary, to prevent severe DKA.