A school nurse is providing dietary teaching for an 11-year-old child who has type 1 diabetes mellitus. The nurse should identify which of the following responses by the child indicates an understanding of the teaching?

Select all that apply.

A. "I should eat extra food on busy days when I am more active." Physical activity lowers blood glucose levels. Eating extra food prevents hypoglycemia during periods of increased activity.
B. "I should increase my intake of sugar-free fluids when I am sick." During illness, maintaining hydration is essential. Sugar-free fluids help prevent dehydration without causing hyperglycemia.
C. "I should eat a snack 30 minutes before my baseball game starts." A pre-activity snack helps maintain blood glucose levels during exercise, reducing the risk of hypoglycemia.
D. "I should wait 2 hours after eating before playing with my friends." There is no need to delay physical activity for 2 hours after eating unless instructed otherwise by a healthcare provider.
E. "I should have a 16-ounce glass of milk if I start feeling weak or shaky." A smaller portion of fast-acting carbohydrates, like 4 ounces of juice or 15 grams of glucose tablets, is recommended for treating hypoglycemia.

A. "I will take my child's rectal temperature daily.": Taking a rectal temperature in a child receiving chemotherapy is not recommended because it increases the risk of rectal injury and infection. An oral or axillary temperature is preferred.
B. "I will make sure to inspect my child's mouth every day for sores." Chemotherapy suppresses the immune system, leaving the child vulnerable to infections such as mucositis. Inspecting the mouth daily is crucial to detect any sores or signs of infection early and prevent complications.
C. "I will make sure my child gets their MMR vaccine this week.": Live vaccines like the MMR (measles, mumps, rubella) vaccine should not be given during chemotherapy or other forms of immunosuppressive treatment.
D. "I will ensure my child exercises a little each day by riding their bicycle.": Exercise may be limited during chemotherapy due to fatigue and increased susceptibility to infection. Physical activity should be tailored to the child's ability and energy level, not mandated.