A 48 years old client presents to the emergency department with fever, severe flank pain, painful and restricted

A 48 years old client presents to the emergency department with fever, severe flank pain, painful and restricted urinary output. The health care provider orders labs that reveal the following: creatinine 4.2 mg/dl; BUN 120 mg/dl, potassium 4.8 mEg/L. The client has a history of recurrent kidney infections and kidney stones. The client also has diabetes, anxiety, joint pain, and venous thrombosis. Current medications include metformin, escitalopram, daily vitamin supplement and use NSAIDSs for muscular pain and associated joint and inflammation. What assessment data are most important and immediate concern for the nurse?