A nurse is admitting a client to the emergency department after a gunshot wound to the abdomen. Which of the following actions should the nurse take to help prevent the onset of acute kidney failure?

A. "I should use a heating pad when my feet are cold.": Clients with diabetes mellitus may have reduced sensation due to peripheral neuropathy. Using a heating pad increases the risk of burns or injury due to the inability to perceive excessive heat.

B. "I should plan to remain barefoot while I am at home.": Walking barefoot increases the risk of foot injuries, which can lead to infections and complications such as diabetic ulcers. Clients should always wear well-fitting shoes, even at home, to protect their feet.

C. "I should apply lotion between my toes twice a day.": Moisturizing the feet is important to prevent dryness and cracking, but applying lotion between the toes can create excess moisture, increasing the risk of fungal infections.

D. "I should file the edges of my toenails after trimming them.": Filing the edges helps smooth sharp corners, reducing the risk of ingrown toenails and foot injuries, which can be difficult to heal in individuals with diabetes.

A. Palpate the dorsalis pedis pulse: Assessing distal pulses ensures adequate circulation to the affected extremity. Impaired blood flow can indicate compartment syndrome or vascular compromise, which are serious complications following fracture stabilization. The nurse should also monitor capillary refill, skin temperature, and sensation.

B. Maintain the affected extremity in a dependent position: Keeping the extremity in a dependent position can increase swelling and venous congestion, leading to complications such as compartment syndrome. Elevation is recommended to minimize edema and promote venous return.

C. Wrap sterile gauze on the sharp point of the pins: The pin sites should be left uncovered to allow for proper monitoring of signs of infection or loosening. Instead, pin site care should be performed per facility protocol to reduce infection risk.

D. Adjust the clamps on the fixator frame: Adjusting the external fixator clamps is outside the nurse's scope of practice. Any modifications to the device should be performed by the orthopedic provider to prevent improper alignment and complications.