A nurse is preparing to administer a medication for a client through a nontunneled percutaneous central catheter. Which of the following actions should the nurse take?

• Infection: Poor glycemic control, indicated by an elevated hemoglobin A1c of 9.5%, leads to impaired immune function, delayed wound healing, and increased risk of postoperative infections. Chronic hyperglycemia promotes bacterial growth, reduces leukocyte function, and compromises vascular integrity, further predisposing the client to infections.
• Deep vein thrombosis (DVT): Postoperative immobility, increased coagulation, and endothelial injury increase DVT risk. However, BUN of 15 mg/dL is within the normal range and does not indicate dehydration or hemoconcentration, which would contribute to thrombus formation.
• Hypovolemia: Reduced blood volume typically presents with signs such as hypotension, tachycardia, and elevated BUN/creatinine ratio. Preoperative hypertension does not indicate hypovolemia and is more commonly associated with chronic vascular resistance rather than acute fluid loss.
• BUN of 15 mg/dL: A BUN level within the normal range does not suggest an increased risk for DVT or fluid imbalance. It primarily reflects renal function and hydration status, neither of which are significantly altered in this case.
• Preoperative hypertension: While chronic hypertension is a cardiovascular risk factor, it does not indicate hypovolemia, which would present with dehydration-related signs such as orthostatic hypotension, tachycardia, and decreased urine output.
• Hemoglobin A1c: A value of 9.5% indicates poor long-term glycemic control, which impairs immune function and slows wound healing. Elevated glucose levels reduce neutrophil function, impair macrophage activity, and increase oxidative stress, all of which contribute to a heightened infection risk.

A. Assess the client's bilateral hand grasp strength: Slurred speech in a client with sickle cell crisis raises concern for stroke due to vaso-occlusion in cerebral vessels. Assessing hand grasp strength helps evaluate for unilateral weakness, a key indicator of stroke, necessitating immediate intervention.

B. Place a padded tongue blade at the client's bedside: There is no indication the client is experiencing a seizure. Seizure precautions are not a priority unless additional neurological symptoms suggest seizure activity.

C. Check the client's bedside glucose level: Hypoglycemia can cause slurred speech, but in a client with sickle cell disease, stroke is a more likely cause. Assessing neurological function should take precedence over checking glucose unless the client has a history of diabetes or other risk factors.

D. Administer flumazenil IV per facility policy to the client: Flumazenil is used to reverse benzodiazepine overdose. There is no indication that the client has received benzodiazepines or is experiencing medication toxicity.