Which patient should the nurse assess first after receiving shift report?

Which patient should the nurse assess first after receiving shift report?

• A. A patient with hemothorax attached to a chest drainage system
• B. A restless elderly patient with pneumonitis
• C. A febrile young patient with influenza
• D. A patient with sinusitis and nasal drainage

Answer: (B)

Assessing the restless elderly patient with pneumonitis first is crucial due to the potential for respiratory complications, especially in an older adult population who may have a decreased reserve and higher risk for deterioration. Pneumonitis can significantly impair gas exchange, leading to hypoxia and increased work of breathing. The patient's restlessness may indicate anxiety, hypoxia, or an exacerbation of their condition, which necessitates immediate evaluation to determine if further interventions, such as oxygen therapy or additional medications, are needed. In contrast, while the patient with hemothorax requires monitoring, the chest drainage system typically allows for adequate management unless there are significant changes noted. The febrile young patient with influenza, while needing care, is generally at lower risk for rapid deterioration compared with someone experiencing respiratory distress. The patient with sinusitis and nasal drainage is also less likely to require immediate assessment, as these symptoms are usually manageable and pose less acute risk compared to potential respiratory failure in the elderly patient with pneumonitis.

Assessing the restless elderly patient with pneumonitis first is crucial due to the potential for respiratory complications, especially in an older adult population who may have a decreased reserve and higher risk for deterioration. Pneumonitis can significantly impair gas exchange, leading to hypoxia and increased work of breathing. The patient's restlessness may indicate anxiety, hypoxia, or an exacerbation of their condition, which necessitates immediate evaluation to determine if further interventions, such as oxygen therapy or additional medications, are needed.

In contrast, while the patient with hemothorax requires monitoring, the chest drainage system typically allows for adequate management unless there are significant changes noted. The febrile young patient with influenza, while needing care, is generally at lower risk for rapid deterioration compared with someone experiencing respiratory distress. The patient with sinusitis and nasal drainage is also less likely to require immediate assessment, as these symptoms are usually manageable and pose less acute risk compared to potential respiratory failure in the elderly patient with pneumonitis.