An adult is admitted with acute flank pain, a 102° F (38.9° C) oral temperature, hematuria, dysuria, urgency, and fishy-smelling urine. Which admitting prescription(s) are most important for the nurse to implement? Select all that apply.

A. Collect a serum sample for hemoglobin and hematocrit: Hemoglobin and hematocrit levels assess for anemia or blood loss but are not the priority for a client showing signs of a severe urinary tract infection or possible pyelonephritis. B. Obtain clean catch urine for culture and sensitivity: A clean catch urine sample is critical to identify the specific organism causing infection and to guide targeted antibiotic therapy, improving treatment effectiveness. C. Give diphenhydramine prep for intravenous pyelogram: Diphenhydramine may be used before contrast studies to prevent allergic reactions, but an imaging study like an IVP is not immediately necessary before addressing infection and stabilization. D. Force oral fluids to 2,000 mL/24 hours: While hydration is important, "forcing" oral fluids to 2,000 mL may be insufficient or inappropriate if the client is experiencing nausea/vomiting or requires IV hydration to maintain hemodynamic stability and renal perfusion. E. Initiate broad spectrum IV antibiotic as secondary infusion: Starting broad-spectrum antibiotics promptly is vital to treat the infection early, especially given systemic symptoms like fever and flank pain, preventing further complications.