Problem:
The nurse on the medical-surgical unit receives hand-off report on four clients. Which client is the priority to assess first? The nurse on the medical-surgical unit receives hand-off report on four clients. Which client is the priority to assess first? Client with rib fractures, respiratory rate 23 breaths/min, heart rate 106 beats/min, oxygen saturation 96% on high-flow nasal cannula Client with sepsis, complains of sudden shortness of breath, diaphoresis, heart rate 125 beats/min, oxygen saturation 71% on nasal cannula 6 L/min Client with sepsis, respiratory rate 22 breaths/min, heart rate 112 beats/min, blood pressure 113/79 (90), oxygen saturation 88% on nonrebreather 15 L/min Client who is recovering from opioid overdose, respiratory rate 14 breaths/minute, heart rate 90 beats/min, oxygen saturation 96% on nasal cannula 2 L/minute