A 21-year-old man presents to the ED complaining of abdominal pain, nausea, and vomiting for 1 day and increased weakness for the last 2 to 3 days.

A 21-year-old man presents to the ED complaining of abdominal pain, nausea, and vomiting for 1 day and increased weakness for the last 2 to 3 days. He states that he is using the bathroom to urinate frequently and is drinking large amounts of water. He has no previous medical problems and is not taking any medications. His BP is 110/72 mm Hg, HR is 119 beats per minute, temperature is 98.8°F, and RR is 14 breaths per minute. On examination, he appears mildly confused, is pale, diaphoretic, and has unusually deep respirations and a fruity odor to his breath. Which of the following is the next best step?

a. Check fingerstick glucose.

b. Administer antiemetics.

c. Administer analgesics.

d. Send basic metabolic panel.

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