Which client should the charge nurse check first after agreeing to cover another nurse's assignment during a lunch break?

The most critical client for the charge nurse to check first is the one with a pneumothorax secondary to a gunshot wound and a current oxygen saturation of 90%. This situation indicates a significant respiratory issue that requires immediate assessment and intervention. An oxygen saturation at 90% suggests hypoxemia, which is a life-threatening condition needing urgent attention.

In cases of pneumothorax, there is a risk of respiratory distress and inadequate oxygen exchange. The charge nurse must prioritize this client to ensure that oxygenation is restored, and any potential progression to respiratory failure is prevented. Monitoring vital signs and the client’s overall respiratory status is essential in this scenario to determine if further medical interventions, such as chest tube insertion or supplemental oxygen, are warranted.

While the other clients also have concerning conditions, the immediate threat to life posed by low oxygen saturation in the client with the pneumothorax makes them the top priority. Recognizing and acting upon the severity of respiratory compromise is crucial in nursing practice, particularly in high-stakes environments.