Which client should the nurse follow up with first among the assigned patients?

The priority for follow-up in this scenario should be the client receiving mechanical ventilation with the low-pressure alarm sounding. When the low-pressure alarm is activated on a mechanical ventilator, it typically indicates an issue such as a loss of airway pressure, which could suggest that the endotracheal tube may be dislodged or there is a leak in the ventilatory circuit. This situation poses an immediate risk to the patient's oxygenation and ventilation, making it critical for the nurse to assess and intervene quickly to ensure the patient maintains adequate breathing support.

In contrast, while the other clients present with significant concerns such as the new colostomy patient who refuses care or the patient with acute glomerulonephritis exhibiting periorbital edema, these situations do not pose an immediate threat to life or require urgent intervention in the same manner as a ventilator issue does. Similarly, while atrial fibrillation with an irregular pulse requires monitoring and may necessitate adjustments in treatment, it does not generally require as urgent a response as a mechanical ventilation problem that could immediately compromise the patient’s safety.

Therefore, following up with the patient on mechanical ventilation is the most critical action to ensure patient safety and effectiveness of care.