The nurse is assessing a client who reports falling 2 days ago and has a history of gouty arthritis that is controlled with allopurinol. The client reports the left knee is swollen and extremely painful to touch. Which instruction should the nurse include in the discharge teaching?

A. Listening for extra heart sounds, murmurs, and rhythm is important, but obtaining an ECG and starting continuous monitoring should be prioritized to assess for possible acute coronary syndrome.

B. Reducing environmental stimuli is beneficial for patient comfort but is not the immediate priority in assessing and managing potential cardiac events.

C. Obtaining a 12-lead electrocardiogram and beginning continuous cardiac monitoring are critical actions to diagnose and monitor for myocardial infarction or other cardiac events. These steps provide vital information for immediate treatment decisions.

D. Restricting family and visitors may be necessary but is not the immediate next action compared to performing an ECG and continuous monitoring to assess the client's cardiac status.

Select Response 1: First thing in the morning fasting

Monitoring blood glucose levels first thing in the morning while fasting helps assess the client’s baseline glucose level after an overnight fast. This is important for evaluating overall glucose control and adjusting treatment if necessary.

Select Response 2: Prior to each meal

Checking blood glucose levels before each meal provides insight into how well the client’s blood sugar is controlled throughout the day and helps adjust dietary and medication plans to maintain optimal glucose levels.