The nurse cares for a pediatric client. Review the electronic health record. Select from the choices below to specify what condition the client is most likely experiencing ____, two actions the nurse should take to address that condition ____ and ____, and two parameters the nurse should monitor to assess the client's progress ____ and ____.

This child's presentation — polyuria, polydipsia (large water intake, asking for juice), warm dry skin, dry mucous membranes, blurred vision ("seeing double"), tachycardia, tachypnea, glucose of 525 mg/dL, elevated serum osmolality at 306, and ketones of 1.8 — is diagnostic of new-onset type 1 diabetes with developing diabetic ketoacidosis, reflecting insulin insufficiency. The sputum culture is negative and the lungs are clear, ruling out pulmonary infection; vital signs and clinical picture do not support sepsis. The two essential interventions are intravenous fluid resuscitation to correct dehydration and reduce serum osmolality, followed by initiation of insulin (often as a continuous infusion, with lispro used per institutional pediatric DKA protocols) to halt ketogenesis and lower glucose gradually. Diuretics would worsen the existing volume deficit, bronchodilators are unnecessary because the lungs are clear, and antibiotics are not indicated without evidence of infection. The two most important monitoring parameters are serum osmolality, which must be reduced slowly to prevent cerebral edema (the feared complication of pediatric DKA), and blood glucose levels, which guide insulin titration and the timing of adding dextrose to fluids. Respiratory assessments, blood cultures, insulin sensitivity, and oxygen saturation are less specific to managing DKA progression.