Which of the following provider prescriptions and orders should the nurse anticipate?

Administer furosemide 20 mg IV now This is not anticipated. Furosemide is a loop diuretic used for fluid overload, but the client is already hypovolemic with hypotension (BP 94/52) and poor skin turgor. Giving furosemide would worsen dehydration and electrolyte imbalance. Administer oxygen at 2 L via nasal cannula This is not anticipated. The client’s oxygen saturation is 97% on room air, which is adequate. Oxygen therapy is not required unless hypoxemia develops. Obtain vital signs hourly This is anticipated. The client is in diabetic ketoacidosis (DKA) with hypotension, tachycardia, tachypnea, and electrolyte abnormalities. Hourly monitoring is essential to detect rapid changes in hemodynamic status and response to therapy. Administer metformin 500 mg PO twice daily This is not anticipated. Metformin is contraindicated in type 1 diabetes mellitus and in acute illness with risk of lactic acidosis. The client is already prescribed IV insulin, which is the correct therapy for DKA. Infuse 0.9% sodium chloride IV at 15 mL/kg for 1 hr This is anticipated. The client is severely dehydrated with poor skin turgor, dry mucous membranes, hypotension, and tachycardia. Rapid fluid resuscitation with isotonic saline is the first-line intervention in DKA to restore perfusion and support circulation before insulin therapy takes full effect.