A nurse is caring for a client who has diabetes insipidus and has had a urinary output of 3,000 mL in the past 12 hr. Which of the following medications should the nurse expect to administer to the client?

• Pain level: Chest pain rated at 7/10 with radiation to the left arm, along with diaphoresis and nausea, indicates a potential acute coronary syndrome, likely a myocardial infarction. Immediate intervention is necessary to relieve pain and address the underlying cause, as this could prevent further complications and potential cardiac damage.
• Electrocardiogram findings: ST-segment elevation and T wave changes suggest an ST-elevation myocardial infarction (STEMI), which requires urgent medical attention. Prompt identification and activation of treatment protocols, such as percutaneous coronary intervention (PCI) or thrombolytic therapy, are critical to restore blood flow and minimize myocardial damage.
• Troponin T level: An elevated troponin T level (0.40 ng/mL, with a normal range <0.1 ng/mL) indicates myocardial injury, supporting the diagnosis of an acute myocardial infarction. Immediate management is essential to mitigate further cardiac injury and ensure appropriate treatment is initiated based on the severity of the elevation.
• Blood pressure: While the blood pressure reading of 164/80 mm Hg indicates hypertension, it is not critically high and does not require immediate intervention like the other findings. However, elevated blood pressure in the context of a myocardial infarction can increase myocardial oxygen demand, leading to further complications, thus it should be monitored closely.

• Blood glucose level: The blood glucose level of 103 mg/dL is within normal limits (74-106 mg/dL) and does not indicate an immediate concern. Although monitoring blood glucose is essential in clients with diabetes, it is not a priority in the context of acute coronary syndrome.
• Bowel sounds: The presence of bowel sounds indicates gastrointestinal function and does not require immediate follow-up in this context. While it’s important to assess overall health, bowel sounds are not a priority when addressing acute cardiac symptoms.
• Lung sounds: Clear lung sounds indicate that there is no pulmonary congestion or other respiratory complications at this time. While lung assessment is essential for overall patient evaluation, clear lung sounds do not require immediate follow-up in this acute setting.

A. "I should use a heating pad when my feet are cold.": Clients with diabetes mellitus may have reduced sensation due to peripheral neuropathy. Using a heating pad increases the risk of burns or injury due to the inability to perceive excessive heat.

B. "I should plan to remain barefoot while I am at home.": Walking barefoot increases the risk of foot injuries, which can lead to infections and complications such as diabetic ulcers. Clients should always wear well-fitting shoes, even at home, to protect their feet.

C. "I should apply lotion between my toes twice a day.": Moisturizing the feet is important to prevent dryness and cracking, but applying lotion between the toes can create excess moisture, increasing the risk of fungal infections.

D. "I should file the edges of my toenails after trimming them.": Filing the edges helps smooth sharp corners, reducing the risk of ingrown toenails and foot injuries, which can be difficult to heal in individuals with diabetes.