A client is showing signs of respiratory distress. What is most crucial for the nurse to assess first?

Assessing the breathing pattern is the most crucial action when a client exhibits signs of respiratory distress. Respiratory distress indicates that the client's ability to breathe effectively is compromised, which can lead to a decrease in oxygen levels and potential respiratory failure if not addressed promptly. Evaluating the breathing pattern provides vital information about the client's respiratory rate, depth, and effort, which are critical in determining the severity of the distress and guiding further interventions.

For instance, an increased respiratory rate could signal a compensatory response to hypoxia, while shallow breathing might indicate fatigue or impending respiratory failure. Observing any use of accessory muscles, retracting of the chest wall, or abnormal lung sounds would also be part of assessing the breathing pattern. This focused assessment helps prioritize interventions such as administering supplemental oxygen or preparing for potential advanced airway management.

While heart rate, blood pressure, and capillary refill are important indicators of overall health and can provide additional context about the client's condition, they do not directly address the immediate concern of respiratory function. Addressing breathing first is paramount in acute care settings, as it has the most direct impact on the client's oxygenation and overall stability.