The nurse just received the shift report on her group of clients. Based on the information she received, which client should she assess first?

• A. A client who underwent a right nephrectomy yesterday and is complaining of pain
• B. A client who is stable and sleeping
• C. A client with a routine check-up
• D. A client with a fever unrelated to GU issues

Answer: (A)

The priority is the client who recently had nephrectomy and is reporting pain. After major surgery, new or increasing pain can signal a potentially life-threatening complication such as acute bleeding or evolving infection. This situation demands immediate assessment to evaluate the patient’s hemodynamic status and surgical site. Check vital signs for instability (like a rising heart rate or dropping blood pressure), examine the incision and any dressings or drains, monitor urine output and color, and assess the intensity, location, and character of the pain. If there are any signs of hemorrhage or hemodynamic compromise, act quickly by notifying the surgeon and preparing for further intervention. The other clients are more stable at this moment, making the post-op, pain-presenting client the one to assess first.