A nurse is admitting a client from a provider's office. Click to highlight the provider prescriptions the nurse should implement first. Vital signs on admission and every 4 hr NPO Complete blood count Basic metabolic profile Arterial blood gases Hemoccult stool Stool culture and sensitivity Urine culture and sensitivity Sitz baths up to 3 times daily PRN Medications: Dextrose 5% in 0.45% sodium chloride IV at 125 mL/hr Metoclopramide 10 mg IV every 6 hr PRN nausea/vomiting Ciprofloxacin 400 mg IV every 12 hr

Dextrose 5% in 0.45% sodium chloride IV at 125 mL/hr. The client exhibits clinical signs of hypovolemic shock, including a heart rate of 122/min, blood pressure of 96/48 mm Hg, and dark concentrated urine. Restoring intravascular volume is the highest priority to maintain organ perfusion and reverse the 48-hour fluid loss from vomiting and diarrhea. Intravenous rehydration directly addresses the fluid volume deficit identified in the provider's physical assessment. This intervention must be initiated immediately to stabilize the patient's deteriorating hemodynamic status. Stool culture and sensitivity. In cases of suspected foodborne illness with hematochezia and febrile illness, identifying the specific enteric pathogen is essential for targeted therapy. Obtaining the specimen before the administration of the first dose of antibiotics ensures the diagnostic integrity of the culture results. This diagnostic step allows the healthcare team to differentiate between various bacterial, viral, or parasitic causes of gastroenteritis. The nurse must prioritize collection to guide the transition from empiric to definitive antimicrobial treatment. Urine culture and sensitivity. The report of dark, concentrated urine and decreased output suggests potential pre-renal azotemia or a concurrent urinary tract infection contributing to the febrile state. Collecting a urine sample before starting systemic antibiotics is a standard nursing priority to ensure accurate identification of any bacteriuria. This data helps the provider rule out systemic complications or alternative sources of infection in a lethargic, febrile patient. Accurate cultures are critical for antimicrobial stewardship and ensuring the most effective treatment plan is followed. Ciprofloxacin 400 mg IV every 12 hr. Administering empiric antibiotics is a priority for a patient showing signs of systemic infection, including a temperature of 39° C and tachycardia. Ciprofloxacin provides broad-spectrum coverage against common gram-negative enteric pathogens associated with undercooked meat and contaminated food. Rapid initiation of antimicrobial therapy reduces the risk of the infection progressing to bacteremia or septicemia. This intervention should follow the collection of cultures but must not be delayed significantly in a hemodynamically unstable client.