The nurse is caring for a patient diagnosed with a small bowel obstruction who has frequent vomiting and diarrhea. Select the three (3) highest priority goals that the nurse prioritizes in the plan of care. Select all that apply by selecting the 3 highest priority answers.

A. Urinary output > 30 ml/hr: Maintaining adequate urine output is a key indicator of renal perfusion and overall fluid status. In small bowel obstruction with vomiting and diarrhea, significant fluid losses can lead to hypovolemia, so monitoring urine output helps assess effectiveness of fluid resuscitation and perfusion to vital organs. B. Fluid and electrolyte balance: Frequent vomiting and diarrhea lead to substantial losses of fluids, sodium, potassium, and chloride, placing the patient at high risk for dehydration and electrolyte imbalances. Restoring and maintaining balance is essential to prevent complications such as arrhythmias, metabolic alkalosis, or shock. C. Prevention of nausea: While nausea is distressing and requires management, it is not a top priority compared to life-threatening concerns such as fluid depletion and hemodynamic instability. Symptom control is important but follows stabilization of physiological status. D. Maintain skin integrity: Skin care is important, especially with diarrhea, but it is a lower priority compared to maintaining circulation and fluid balance. It does not directly address the immediate risk of hypovolemia or compromised organ perfusion. E. Maintain a MAP > 65 mmHg: Mean arterial pressure reflects adequate systemic perfusion, and maintaining MAP ≥65 mmHg is critical to ensure blood flow to vital organs. In the setting of fluid loss, hypotension can rapidly progress to shock, making this a high-priority hemodynamic goal. F. Prevent infection: Infection prevention is always important, particularly if invasive interventions are required, but it is not the immediate priority in an acute obstruction with active fluid loss. Stabilizing circulation and correcting imbalances take precedence.