The nurse is caring for a client who develops signs and symptoms of septic shock following a urinary tract infection one week ago. The healthcare provider prescribes a sepsis protocol to be initiated. Which intervention is most important for the nurse to include in the plan of care?

A. Maintaining strict intake and output is crucial in managing septic shock, as it helps assess kidney function and fluid balance, which are vital in this critical condition. B. Keeping the head of bed raised can help with respiratory function, but it is not the primary focus in septic shock management. C. Assessing warmth of extremities is important but does not provide immediate information about the client’s hemodynamic status. D. Monitoring blood glucose levels is important for overall care, especially if the patient is receiving insulin or has diabetes, but it is not the most critical intervention in the context of septic shock.