A nurse is caring for a 73-year-old client in the emergency department (ED). Exhibits It has been identified that the client is in sepsis. Select the 4 actions that the nurse should complete in the first hour to manage sepsis and prevent further complications?

A. Insert a nasogastric (NG) tube. Not part of the first-hour sepsis bundle; used for gastric decompression or nutrition later if needed. B. Obtain blood cultures. Cultures must be drawn before antibiotics to identify the causative organism. C. Rapidly administer 30 mL/kg of normal saline. Initial fluid resuscitation is essential to correct hypotension and improve perfusion. D. Measure lactate level. Elevated lactate indicates tissue hypoperfusion and helps guide treatment effectiveness. E. Administer broad-spectrum antibiotics. Timely antibiotics reduce mortality; must be given within 1 hour. F. Obtain a urine specimen. May help identify infection source, but not a priority in the first hour. G. Obtain a wound culture. Can be done later; blood cultures are the priority in sepsis. H. Type and cross-match for 2 units of packed RBCs. Only needed if there's evidence of hemorrhagic shock or anemia, which is not the case here.