The nurse is stabilizing the client and preparing her for surgery. Which goal(s) should the nurse prioritize in the plan of care (POC) for the client while in the emergency department (ED)? Select all that apply.

A. Effective coping with illness related anxiety: While addressing anxiety is important, it is not the most immediate priority in the emergency setting for a client with suspected acute appendicitis. Stabilization, pain control, and prevention of complications take precedence over psychosocial interventions, which can be incorporated later once the client is hemodynamically stable. B. Fluid volume management: The client has experienced vomiting and may be at risk for dehydration, electrolyte imbalance, and hypovolemia. Administering IV fluids and monitoring intake and output are essential to maintain hemodynamic stability and prepare the client for surgery, making fluid volume management a high-priority intervention in the ED. C. Client education about diagnosis and plan of care (POC): Educating the client about her diagnosis and surgical plan is important for informed consent and cooperation and is a legal and ethical requirement. The client must understand her diagnosis (appendicitis) and the necessity of the appendectomy. Education also helps reduce the "fear of the unknown," which directly impacts her reported anxiety. D. Relief of acute pain: The client reports severe abdominal pain (9/10) in the right lower quadrant. Controlling acute pain not only improves comfort but also helps reduce sympathetic nervous system stress, prevents tachycardia and hypertension, and allows more accurate ongoing assessment of abdominal status. Pain management is a priority while awaiting surgery. E. Promotion of bowel routine: Promoting regular bowel movements is not a priority in a client with acute appendicitis in the ED. Interventions to stimulate bowel function may be contraindicated prior to surgery, as they could exacerbate symptoms or risk perforation. This goal is more appropriate postoperatively once bowel function returns. F. Prevention of deep vein thrombosis (DVT) related to immobility: While DVT prevention is important for hospitalized clients, the client is still in the early emergency phase and able to ambulate prior to surgery. Immediate attention is on stabilization, fluid management, pain control, and infection prevention; DVT prophylaxis will become more relevant postoperatively. G. A review of diet progression postoperatively: Dietary management is important postoperatively but is not an immediate priority in the ED. The client is currently NPO in preparation for surgery, so addressing diet progression is deferred until after the procedure. H. Infection prevention related to illness: The client has laboratory and imaging findings consistent with acute appendicitis, which carries a high risk for infection or perforation. Implementing infection prevention strategies such as timely administration of IV antibiotics, maintaining sterile technique for IV access, and preparing for surgical intervention is a high-priority goal to reduce morbidity.