A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a history of dysphagia. Which of the following instructions should the nurse include in the teaching?

A. "Take an extra dose of insulin lispro prior to aerobic exercise." This is incorrect. Exercise can increase insulin sensitivity, meaning the client may need to reduce the dose of short-acting insulin (such as insulin lispro) before exercise to avoid hypoglycemia. The nurse should not recommend taking an "extra" dose of insulin prior to exercise.

B. "Draw up the insulin lispro and insulin glargine in separate syringes." This is correct. Insulin lispro (a rapid-acting insulin) and insulin glargine (a long-acting insulin) should never be mixed in the same syringe. Insulin glargine is acidic, and mixing it with other insulins can alter its action and effectiveness.

C. "Expect insulin glargine to be cloudy." This is incorrect. Insulin glargine should be clear and colorless. If insulin glargine appears cloudy, it may indicate that the insulin is expired or has been improperly stored.

D. "Anticipate that the insulin glargine will peak in 3 hours." This is incorrect. Insulin glargine has no pronounced peak. It provides a steady release of insulin over 24 hours and is designed to be taken once daily.

A. The client should use a hair dryer on a warm setting to relieve itching inside the cast is incorrect. Using a hair dryer could cause skin burns or damage the cast. Additionally, the client should avoid introducing moisture into the cast, which could lead to skin irritation or infection.

B. The client's extremity should be elevated after the cast is applied is correct. Elevating the extremity helps reduce swelling and inflammation during the initial phase after cast application. It is important to elevate the limb above the level of the heart to promote venous return and reduce swelling.

C. The client can shower with the cast after 24 hr is incorrect. The plaster cast should not get wet. The nurse should instruct the client to keep the cast dry at all times. A plastic cover or cast protector should be used when showering to prevent moisture from seeping into the cast.

D. The client should keep the cast covered until it is dry is incorrect. It is true that the cast should be kept dry, but keeping it covered is not enough. The primary concern is preventing moisture and ensuring the plaster cast is allowed to air dry in a well-ventilated area without getting wet.