A nurse working in an emergency department is triaging four clients. Which of the following clients should the nurse recommend for treatment first?

A. Correct. A 6-month-old infant who has croup and an O2 saturation of 92% on room air is at risk of respiratory distress and hypoxia. Croup causes inflammation and narrowing of the upper airway, which can compromise breathing. An O2 saturation of 92% is below the normal range of 95% to 100% and indicates inadequate oxygenation. This child needs immediate assessment and intervention to prevent further deterioration.

B. Incorrect. A 15-year-old adolescent who is 2 hr postoperative following an open reduction and internal fixation of the left ankle and is requesting pain medication has a priority need for pain management, but not as urgent as a child with respiratory compromise. The nurse should assess the adolescent's pain level, administer the prescribed analgesic, and monitor the effectiveness of the medication.

C. Incorrect. A 3-year-old toddler who has gastroenteritis, moderate dehydration, and had two loose bowel movements over the past 24 hr has a potential risk for fluid and electrolyte imbalance, but not as acute as a child with respiratory compromise. The nurse should monitor the toddler's intake and output, vital signs, weight, and skin turgor, and administer oral or intravenous fluids as prescribed.

D. Incorrect. A 10-year-old child who is awaiting surgery for an appendectomy and experienced sudden relief from pain may have a perforated appendix, which can lead to peritonitis and sepsis. However, this child is not as unstable as a child with respiratory compromise. The nurse should notify the surgeon of the change in pain status, monitor the child's vital signs, abdominal assessment, and laboratory results, and prepare the child for surgery.

A. A client who has cellulitis and is receiving oral antibiotics every 8 hr has a mild to moderate infection that can be managed at home with proper wound care and medication adherence. The client does not require hospitalization unless there are signs of systemic infection or complications.

B. A client who is postoperative following an upper endoscopy procedure and is alert but does not have a gag reflex has a high risk of aspiration and airway obstruction due to impaired swallowing function. The client requires close monitoring and intervention until the gag reflex returns, which can take several hours or longer depending on the type and amount of anesthesia used.

C. A mother and their newborn 12 hr postdelivery have not completed the minimum recommended stay of 24 to 48 hours for uncomplicated vaginal deliveries or 72 to 96 hours for cesarean deliveries, according to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. The mother and their newborn require assessment, education, support, and follow-up care to ensure their health and well-being.

D. A client who has lower extremity weakness and is newly admitted for observation has an undiagnosed condition that could indicate a serious neurological or vascular problem, such as stroke, spinal cord injury, or peripheral artery disease. The client requires diagnostic testing, evaluation, treatment, and rehabilitation to prevent further deterioration or complications.