Which of the following instructions should the nurse include when reinforcing discharge teaching to the client? Select all that apply.

Discharge planning for a patient recovering from diabetic ketoacidosis focuses on preventing recurrence through consistent glucose monitoring, early identification of metabolic stressors, and prompt management of both hypo and hyperglycemic events to maintain glycemic control and metabolic stability after returning home. Choice A rationale: Monitoring blood glucose levels is the cornerstone of type 1 diabetes management. Frequent checks are essential for the client to make informed decisions regarding insulin dosing and to identify trends that may require adjustment to prevent future ketoacidosis episodes. Choice B rationale: Testing urine for ketones is critical during periods of illness or when blood glucose levels are consistently elevated. This allows the client to identify the onset of ketoacidosis early and seek medical attention before it becomes a life-threatening crisis. Choice C rationale: If blood glucose drops below 70 mg/dL, the client is experiencing hypoglycemia. Ingesting 15 grams of fast-acting carbohydrates is the standard intervention to rapidly raise blood glucose levels and prevent a progression to severe, symptomatic neuroglycopenic complications. Choice D rationale: While exercise improves insulin sensitivity, it is not recommended during acute illness or when ketones are present in the urine. Excessive activity in a poorly controlled metabolic state can worsen hyperglycemia and ketosis, posing a significant safety risk to this client. Choice E rationale: The client must be able to recognize the signs of both hyperglycemia, such as polyuria and thirst, and hypoglycemia, such as shakiness and confusion. Prompt identification of these states allows the client to intervene immediately to restore balance and avoid complications. Choice F rationale: Maintaining adequate hydration is important, but 1 liter of fluid daily is insufficient for most individuals, especially those with diabetes. Hydration needs vary based on activity and metabolic status, and general recommendations typically exceed 1 liter per day for overall health. Choice G rationale: The client has type 1 diabetes mellitus, which is characterized by absolute insulin deficiency. Oral antidiabetic medications used for type 2 diabetes are ineffective for this condition, and the client must rely on exogenous insulin therapy as prescribed by their healthcare provider.