Question

a nurse is collecting data from a client who reports abdominal pain. further findings reveal the client has a temperature of 39.2° c (102.6° f), a heart rate of 105/min, a soft nontender abdomen, and menses overdue by 2 days. which of the following findings should be the nurses priority? heart rate of 105; soft, nontender abdomen; temperature; overdue menses

Explanation:

To determine the nurse's priority, we analyze each finding:

• A heart rate of 105/min (tachycardia) can indicate hemodynamic instability or an underlying acute condition, requiring immediate assessment as it may signal a more urgent physiological change.
• A soft, nontender abdomen is a relatively benign finding and not an immediate threat.
• While a fever (39.2°C) is concerning, tachycardia often correlates with acute decompensation or infection severity, and addressing hemodynamic status (heart rate) is prioritized to prevent further complications.
• Overdue menses, though relevant, is less urgent than acute physiological changes like tachycardia.

Answer:

A. Heart rate of 105