A client is admitted to the hospital with chest pain and shortness of breath. The nurse obtains a history and performs a physical examination.

Which of the following information should the nurse report to the provider immediately?

"Wash your hands with warm water and soap before testing."

Rationale: The nurse should instruct the client to wash their hands with warm water and soap before testing, as this helps to prevent infection and remove any substances that may interfere with the accuracy of the test result.

Incorrect options:

B) "Use alcohol wipes to clean your finger before pricking it." - This is an incorrect instruction, as using alcohol wipes to clean the finger can dry out and irritate the skin, and may also affect the test result if the alcohol is not completely dry before pricking.

C) "Squeeze your finger firmly to obtain a drop of blood." - This is an incorrect instruction, as squeezing the finger firmly can cause hemolysis or dilution of the blood sample, leading to inaccurate readings. The client should apply gentle pressure to the finger after pricking it.

D) "Choose a different finger for each test throughout the day." - This is an incorrect instruction, as choosing a different finger for each test throughout the day can increase the risk of infection and pain. The client should rotate the testing sites within one finger or use alternate sites, such as the forearm or palm.

The client's blood pressure is 180/100 mm Hg and heart rate is 110 beats/min.

Rationale: The nurse should report the client's blood pressure and heart rate to the provider immediately, as these are signs of hypertensive crisis and tachycardia, which can indicate a serious cardiovascular complication, such as myocardial infarction, stroke, or heart failure.

Incorrect options:

A) The client has a history of hypertension and diabetes mellitus. - This is an important information to obtain from the client, as it indicates risk factors for cardiovascular disease. However, this is not an urgent finding that requires immediate reporting to the provider, as it does not reflect the client's current condition or acuity.

B) The client takes aspirin 81 mg daily and metformin 500 mg twice daily. - This is an important information to obtain from the client, as it indicates the medications that the client is taking for their chronic conditions. However, this is not an urgent finding that requires immediate reporting to the provider, as it does not reflect any adverse effects or interactions of these medications.

D) The client's chest pain radiates to the left arm and is relieved by nitroglycerin. - This is an important information to obtain from the client, as it indicates that the client has angina pectoris, which is chest pain caused by reduced blood flow to the heart muscle. However, this is not an urgent finding that requires immediate reporting to the provider, as it shows that the chest pain is stable and responsive to nitroglycerin.