A nurse is admitting a client who reports tightness in their chest that radiates to left arm. The nurse is reviewing the client's medical record. Select the four findings that require immediate follow-up.

A. Blood glucose level: The client’s blood glucose is 103 mg/dL, which is within normal limits and does not require immediate follow-up in the context of acute chest pain. B. Bowel sounds: Bowel sounds are present in all four quadrants, which is normal and not an immediate concern in this scenario. C. Blood pressure: Although the exact value is not provided, clients with acute coronary syndrome (ACS) can experience hypotension or hypertension, which can worsen myocardial ischemia or compromise perfusion. Blood pressure requires immediate assessment and monitoring. D. Pain level: The client reports a pain level of 7/10 with characteristics suggestive of myocardial infarction (MI). Severe, ongoing chest pain is an emergency and requires rapid intervention, including oxygen, nitroglycerin, or morphine as prescribed. E. Electrocardiogram findings: ST-segment elevation and T-wave changes indicate an acute ST-elevation myocardial infarction (STEMI). This requires immediate intervention, such as reperfusion therapy. F. Lung sounds are incorrect. Lungs are clear to auscultation, which is normal. While pulmonary assessment is important, there is no immediate abnormality requiring urgent follow-up. G. Troponin T level: Troponin T is markedly elevated (0.40 ng/mL, normal <0.1 ng/mL), confirming myocardial injury. Elevated troponin in the context of chest pain and ECG changes requires immediate intervention.