A nurse is providing teaching to an adolescent who has type 2 diabetes mellitus and a new prescription for metformin. Which of the following instructions should the nurse include in the teaching?

A. Green zone reading on peak expiratory flow meter:

A green zone reading on a peak expiratory flow meter indicates that the child's peak expiratory flow rate (PEFR) is within the normal or stable range. This would not typically be indicative of an exacerbation of asthma. In fact, a green zone reading suggests that asthma is well-controlled.

B. Rhinitis:

Rhinitis, or inflammation of the nasal mucosa, is a common symptom in individuals with asthma, but it is not necessarily indicative of an exacerbation of asthma. Rhinitis can occur due to allergic or non-allergic triggers and may be present even when asthma is well-controlled.

C. Axillary temperature of 37.2°C (99°F):

An axillary temperature of 37.2°C (99°F) is within the normal range for body temperature and is not indicative of an exacerbation of asthma. While fever can occur during exacerbations of asthma, it is not a universal symptom and may be absent in some cases.

D. Hacking, nonproductive cough:

This is the correct option. A hacking, nonproductive cough is a common symptom of asthma exacerbation. During an exacerbation, the airways become inflamed and constricted, leading to coughing. The cough may be dry and unproductive, and it is often worse at night or early in the morning.

A. Obtain a daily weight:

This is an appropriate action. Monitoring daily weights can help assess fluid balance and detect fluid retention, which is common in children with kidney disorders like acute glomerulonephritis. Sudden weight gain or fluid overload may indicate worsening kidney function and the need for intervention.

B. Strain the urine:

Straining the urine may be indicated to monitor for the presence of blood or protein, which are common findings in acute glomerulonephritis. Straining the urine is not necessary, as hematuria is a common finding and does not indicate kidney damage.

C. Monitor blood glucose level every 4 hr:

Monitoring blood glucose levels every 4 hours is not directly related to the care of a child with acute glomerulonephritis. Blood glucose monitoring is more relevant in conditions such as diabetes mellitus. However, monitoring electrolyte levels, including blood glucose, may be part of routine laboratory testing in children with kidney disorders.

D. Recommend strict bed rest:

Strict bed rest is not typically recommended for children with acute glomerulonephritis unless there are specific complications or severe symptoms requiring immobilization. While some activity restriction may be recommended during the acute phase of the illness, strict bed rest may lead to complications such as deconditioning and venous thromboembolism.