An assistive personnel tells the nurse that several client measurements were obtained with morning vital signs. Which of the following clients should the nurse plan to assess first?

Choice A reason: A blood pressure of 130/78 mm Hg in a 6-year-old with glomerulonephritis is elevated, but hypertension is an expected complication of glomerulonephritis. This requires monitoring and treatment but is not immediately life-threatening. Choice B reason: A temperature of 39° C (102.2° F) in a 2-year-old with Kawasaki disease is concerning but not immediately life-threatening. Fever is common in Kawasaki disease, and antipyretics and supportive care are indicated. Choice C reason: A heart rate of 60/min in a 4-year-old with a closed-head injury is bradycardic. Normal heart rate for this age is 80–120/min. Bradycardia in the context of a head injury can indicate increased intracranial pressure, which is a medical emergency requiring immediate intervention. This makes it the highest priority. Choice D reason: A respiratory rate of 26/min in an 8-year-old with type I diabetes mellitus is slightly elevated but not critically abnormal. It could suggest early compensation for metabolic acidosis, but it is not as urgent as bradycardia with head injury.