A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?

A. The client reports dizziness when standing: This could indicate orthostatic hypotension or dehydration and should be reported, but it is less immediately dangerous than possible hypoglycemia. B. The client reports urine that is dark yellow in color: Dark urine suggests concentrated urine/dehydration and should be noted, but it is not usually an immediate safety threat. C. The client asks the AP to trim his broken toenail: An AP should not perform toenail trimming for a client with diabetes because of infection risk; this request should be reported but is not the most urgent item. D. The client refuses breakfast and requests to sleep: Skipping a meal while on insulin increases the immediate risk of hypoglycemia, and the client’s request to sleep may prevent recognition of hypoglycemic symptoms, so this must be reported immediately.