Which assessment should the nurse prioritize for a client exhibiting fruity breath odor, dry mouth, and extreme thirst?

Prioritizing the assessment of blood glucose level is crucial in this scenario because the symptoms presented—fruity breath odor, dry mouth, and extreme thirst—are indicative of hyperglycemia, which is often associated with diabetic ketoacidosis (DKA) or uncontrolled diabetes. Fruity breath odor is specifically characteristic of the ketone bodies produced when fats are metabolized instead of carbohydrates due to insufficient insulin. This metabolic state can lead to serious complications if not addressed promptly.

In the context of DKA, blood glucose levels can be significantly elevated. Assessing the blood glucose level will provide immediate information about the client’s current metabolic state and help guide critical interventions. This assessment is foundational for determining whether the client requires insulin therapy or other urgent measures to stabilize their condition.

The other assessments, while potentially relevant for ongoing management and understanding of the patient’s overall health, do not address the immediate concern linked to the symptoms presented. Blood pressure may be affected by fluid balance and dehydration, serum electrolyte levels can provide insight into the patient’s metabolic status, and urinalysis may help identify the presence of ketones or glucose in urine but are not as urgent as confirming blood glucose levels in this particular case.