A. Client reporting incisional pain of 8 on a scale of 0-10 with a respiratory rate of 25/min who had a right pneumonectomy 12 hours ago B. Client with a left pleural effusion who has crackles, absent breath sounds in the left base, and an SpO2 of 94% on room air C. Client with a temperature of 100.4 F (38 C) and a respiratory rate of 12/min who had a small bowel resection 1 day ago D. Client with pneumonia who has a temperature of 100.4 F (38 C), has an SpO2 of 93% on 4 L/min supplemental oxygen, and is becoming restless

First, let's add the missing piece of information for clarity;

The nurse receives the handoff of care report on four clients. Which client should the nurse see first?

The CORRECT ANSWER IS 4.

4. Client with pneumonia who has a temperature of 97.6 F (36.4 C), has an SpO2 of 93% on 4 L/min supplemental oxygen, and is becoming restless [32%]

Explanation:

Acute respiratory failure (ARF) is a serious and deadly disease condition that affects the lungs' capabilities to oxygenate blood and give out carbon dioxide (CO2) ad waste products. ARF could result from aggravation of chronic (such as chronic obstructive pulmonary disease, asthma) or acute (take for instance pneumonia, pulmonary edema) diseases.

Nurses examing for clinical manifestations of ARF should evaluate both respiratory and neurological signs and conditions. Alterations in mental status (such as, confusion, agitation, somnolence) is a usual and mostly ignored symptom whixh may be due to the brain's sensitivity to lack of sufficient oxygenation and the variations in acid-base balance from reserved CO2(as seen in choice 4). Extra signs and symptoms could be observed and called for.