Which client should the nurse assess first after receiving the change of shift report?

The priority in nursing assessment often hinges on the potential for life-threatening conditions and the immediate needs of clients. In this case, the client with diabetes mellitus (DM) and a history of coronary artery disease who is complaining of increased shortness of breath (SOB) requires prompt attention.

The combination of DM and coronary artery disease places this client at a higher risk for cardiovascular complications. Increased shortness of breath could indicate potential acute issues such as heart failure, myocardial infarction, or even respiratory distress, all of which necessitate immediate evaluation and intervention to prevent further deterioration.

While the other clients also require care, they do not present with an immediate danger to their health in the same manner. A skin rash may need to be assessed, but unless there are signs of an allergic reaction or infection, it is generally less urgent. The newly admitted client with a broken leg requires assessment for pain management and possibly surgical intervention, but this situation is not critical at the moment of shift change. Lastly, a client awaiting discharge instructions is stable and can typically wait for assessment without immediate risk to their health.

Thus, prioritizing the assessment of the client with increased shortness of breath aligns with the nursing principle of addressing the most critical needs first to ensure patient safety