A nurse receives reports on four clients. Which client should be seen first?

The most critical client to be seen first is the one with a cast complaining of her arm feeling like it is "sleeping." This description may indicate a potential complication known as compartment syndrome or circulatory compromise, which can occur when swelling or internal pressure increases within a confined space (like within a cast). If not addressed promptly, these conditions can lead to severe tissue damage, necrosis, and long-term disability.

In contrast, while the other clients also have their concerns, they do not present an immediate risk of life-threatening complications. The client with a respiratory rate of 24 and O2 saturation of 92% might indicate a mild respiratory issue, but the oxygen saturation is not critically low, suggesting that immediate intervention for the breathing issue may not be as urgent as assessing circulation for the client with the cast.

The client scheduled for gastric surgery does require attention to ensure timely care, but this can be managed until more pressing problems are addressed. The post-op client with nausea, while uncomfortable, can typically be managed with medication, and this condition does not pose an immediate threat to life or function. Therefore, prioritizing the client with the cast is the most appropriate choice, as their symptoms could lead to serious complications without timely assessment and intervention.