The nurse on a busy surgical unit has just completed receiving the morning shift report. Which client should the nurse assess first? A. A post-gastrectomy client with \(75 \mathrm{~mL}\) bright red nasogastric drainage in the past hour B. A client receiving total parenteral nutrition following a bowel resection C. A diabetic client with a morning blood glucose of \(210 \mathrm{mg} / \mathrm{dL}\) D. A client with pneumonia receiving intravenous antibiotics

Establishing nursing priorities is crucial to effective patient care, especially in a surgical unit with multiple patients requiring attention. The nurse must swiftly triage each patient based on the urgency of their condition, ensuring those in the most critical state are attended to first. In the case of the nurse who has just received the morning shift report, prioritizing the client with active signs of potential complications, such as bleeding, is paramount.

Nursing priorities often follow the ABCs (airway, breathing, circulation) of medical emergencies, but also consider other urgent factors like acute bleeding or signs of infection. A systematic approach, often guided by protocols such as Maslow's Hierarchy of Needs or the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) assessment framework, can assist nurses in making these critical decisions.

Conducting a thorough and effective client assessment is key to identifying which patient requires immediate attention. The nurse must collect and interpret data concerning the patients' health status by observing vital signs, reviewing medical history, and understanding recent surgical procedures or treatments. The client presenting with symptoms that may indicate a rapid deterioration in their condition, such as bright red drainage suggestive of active bleeding after a gastrectomy, must be prioritized over less urgent cases.

This process revolves around recognizing changes or abnormalities and determining their potential impact on the patient's overall well-being. The use of a focused assessment approach, in this case, helps in quickly identifying the leading clinical problem that could translate into a life-threatening situation if not addressed swiftly.

Postoperative care is a critical component of the nursing responsibilities, particularly for clients who have recently undergone surgery. This period is characterized by the need for close monitoring to prevent, recognize, and respond to potential complications. Key aspects include managing pain, monitoring for signs of infection, ensuring proper wound care, and assessing the functionality of surgical drains.

For instance, in the given scenario, the nasogastric drainage of 'bright red' suggests active bleeding, which is an immediate postoperative care concern that may require rapid intervention to prevent complications such as hypovolemia or shock. Understanding postoperative care norms enables the nurse to differentiate between usual post-surgery symptoms and alarming signs that indicate a deviation from the expected recovery process.