Which client should the nurse see first on a medical floor?

The client with an INR of 6.0 who has a history of rectal bleeding should be prioritized first by the nurse. An INR of 6.0 signifies that the blood is significantly thinner than normal, which poses a high risk for uncontrollable bleeding. In addition, the patient’s history of rectal bleeding further increases this risk, indicating a serious situation that could lead to life-threatening complications if not addressed promptly.

In this case, the potential for a bleed to occur or to exacerbate is critical and could result in significant morbidity or mortality. This situation necessitates immediate assessment, intervention, and potential administration of vitamin K or fresh frozen plasma to reverse the anticoagulation effects.

In the context of the other clients, while a pulmonary embolism with dyspnea is serious and requires prompt attention, the immediate danger of potential bleeding from the client with the elevated INR takes precedence. Similarly, although the client with congestive heart failure has an elevated BNP indicating exacerbation, and the client with acute pancreatitis presents with a serum calcium that is on the lower side of normal, neither of these conditions poses the immediate life-threatening risk that the elevated INR presents. Therefore, the risk of bleeding due to the high INR and previous rectal bleeding must