A nurse is providing teaching to a client who is scheduled for a kidney transplantation. Which of the following statements by the client indicates an understanding of the teaching?

Rationale for Correct Choices

• Blood glucose: A blood glucose level of 250 mg/dL is critically elevated and puts the client at risk for complications such as delayed wound healing, infection, dehydration, and diabetic ketoacidosis (DKA) if unmanaged. Hyperglycemia impairs immune function and must be addressed promptly to stabilize the client's condition and support healing.
• Wound : The draining, non-healing foot ulcer with purulent discharge indicates infection. However, uncontrolled glucose is a major contributing factor to poor wound healing and increased infection risk. Once glucose levels are addressed, wound care becomes the next critical focus to prevent systemic infection and further tissue damage.

Rationale for Incorrect Choices

• Temperature: While the client has a low-grade fever (38.3°C), which may be related to the infected wound, treating the source of infection and controlling glucose will have a greater and more direct impact on resolving the fever.
• Blood pressure: The blood pressure of 98/74 mm Hg is slightly low but not emergent and does not pose immediate risk. It can be monitored while more pressing concerns—like glucose and wound infection—are managed.
• WBC count: The WBC count of 9,500/mm³ is within normal limits. Although it helps in evaluating infection, it does not require direct intervention and is not a clinical priority compared to glucose control and wound care.

A. Use the autoinjector if shortness of breath is the only symptom of anaphylaxis: An epinephrine autoinjector should be used for any signs of anaphylaxis, not just shortness of breath. Symptoms such as hives, swelling, or difficulty breathing should all trigger its use.

B. Use the second autoinjector immediately after the first dose: The second dose of epinephrine is typically used if symptoms persist or recur after 5 to 15 minutes, not immediately after the first dose. The client should call emergency services after using the first dose and only use a second dose if directed by a healthcare provider.

C. Hold the autoinjector firmly down for 10 seconds while injecting: The correct procedure for using the epinephrine autoinjector is to hold it in place for 10 seconds to ensure the full dose is administered. This is an important step to ensure the medication is fully delivered.

D. Inject into the buttock or deltoid: The epinephrine autoinjector should be injected into the outer thigh (vastus lateralis muscle), not the buttock or deltoid. The thigh muscle allows for rapid absorption of the medication in an emergency.