The client is a 34-year-old man presenting to the emergency department with reports of heart palpitations

The client is a 34-year-old man presenting to the emergency department with reports of heart palpitations during the previous hour. The client denies chest pain, relevant cardiac history, and smoking or drug use. The client reports increasing fatigue and weight gain over the past several weeks. The client has a history of diabetes mellitus type 2 and anxiety. The client states he only had water after his noon insulin dose, hoping it would help him “wake up.” Review of systems remarkable for rapid pulse and sinus tachycardia on electrocardiogram (ECG). All other systems within normal limits.