Which client should be assessed first by the nurse?

In this scenario, the client who is two hours post-tonsillectomy reporting throat pain should be assessed first due to the potential for post-operative complications. After a tonsillectomy, patients are at risk for bleeding, particularly within the first few hours after the procedure. Throat pain is a common symptom after this surgery; however, it is crucial to also assess for signs of hemorrhage, which can manifest as increased pain, frequent swallowing, or spitting up blood. This time frame is critical because early detection of any complications that could arise following surgery is essential for effective intervention and management.

While the other clients also require nursing attention, their situations may not present the same immediate risk. The client with COPD using pursed-lip breathing is likely utilizing a method to aid in breathing, which suggests they are currently stable enough to manage their condition. The client who had laparoscopic cholecystectomy and reports shoulder pain may be experiencing referred pain, which is common and typically less critical. Lastly, the client with ulcerative colitis reporting three bloody stools indicates a need for attention, but this scenario is often managed based on the established severity and can be deferred to prioritize any immediate surgical complications from the tonsillectomy. Thus,