A nurse is reinforcing teaching with an adolescent who has warts on his hands. Which of the following instructions should the nurse include?

A. This statement reflects proper site rotation within a specific anatomical area. Rotating injections within the same general area (e.g., abdomen, thigh, upper arm) after 4–6 injections helps prevent lipohypertrophy while maintaining consistent absorption rates. Proper rotation within a single area is safer than frequently changing anatomical sites.

B. Aspiration is not recommended for subcutaneous insulin injections because the risk of injecting into a blood vessel is extremely low and aspiration can increase pain or tissue trauma.

C. Subcutaneous insulin should generally be injected at a 90-degree angle for most children and adults. A 30-degree angle is only used in very thin individuals to avoid intramuscular injection. Using a 30-degree angle routinely may reduce absorption consistency.

D. Glargine (long-acting insulin) should never be mixed with other insulins in the same syringe because it alters its pharmacokinetics. Mixing can lead to unpredictable absorption and blood glucose fluctuations. Only certain short-acting and intermediate-acting insulins can be safely mixed if prescribed.

A. Isotretinoin does not typically alter potassium levels. Routine monitoring of potassium is not indicated in healthy adolescents taking isotretinoin, as the medication does not have known effects on renal potassium handling or cause electrolyte imbalances in this context. Monitoring potassium is only relevant if the patient has other conditions or medications that affect electrolytes.

B. Isotretinoin can cause hyperlipidemia, increasing cholesterol and triglyceride levels, which may raise the risk for pancreatitis or long-term cardiovascular issues. Baseline lipid panels are obtained before starting therapy, with periodic monitoring during treatment to detect and manage elevations promptly.

C. Isotretinoin is not nephrotoxic, meaning it does not typically impair kidney function. Routine monitoring of BUN and creatinine is not necessary unless the adolescent has preexisting kidney disease or other risk factors. Focus should remain on labs directly affected by the medication.

D. Isotretinoin has no significant impact on serum sodium levels. Hyponatremia is not a known complication of isotretinoin therapy, so routine sodium monitoring is unnecessary in otherwise healthy clients. Laboratory monitoring should prioritize liver function tests and lipid profiles, which are more likely to be affected.