A client with a history of anxiety and asthma had an open cholecystectomy 3 days ago. Shortly after ambulating to the bathroom, the client is restless and troubled by shortness of breath. Which action should the nurse implement first?

A. Encourage the use of an albuterol inhaler: Although asthma is part of the client’s history, administering albuterol without assessment might delay recognition of a more serious complication, such as pulmonary embolism. B. Administer a PRN dose of alprazolam: Anxiety may worsen shortness of breath, but treating symptoms as psychological without an assessment may overlook critical conditions like hypoxia or embolism. C. Observe the incision for bleeding or dehiscence: While checking the incision is important, it is not the priority in a client with acute respiratory symptoms. Incisional issues are unlikely to cause sudden-onset dyspnea and restlessness following ambulation. D. Evaluate vital signs including oxygen saturation: The priority action is to assess the client’s current respiratory and circulatory status. Acute shortness of breath and restlessness may indicate hypoxia, pulmonary embolism, or another life-threatening event, and vital signs will help guide urgent interventions.