Which client should a nurse assess first after receiving change-of-shift report?

The priority in this scenario is to assess the client who has COPD and dementia and experienced agitation during the night shift. This choice reflects the principle of prioritizing clients based on their stability and potential for complications.

In the case of clients with chronic obstructive pulmonary disease (COPD), agitation can signify worsening respiratory status, which could lead to serious complications if not addressed promptly. The interplay of COPD and dementia further complicates the situation, as the client may have difficulty communicating their needs or distress. Therefore, assessing this client first allows the nurse to evaluate their respiratory function, address any anxiety or confusion they may be experiencing, and implement necessary interventions to stabilize their condition.

The other clients present less immediate risks to their health. A scheduled dressing change is routine and can be performed after assessing more critical patients. A client with stable vital signs does not require immediate attention unless their condition changes. A client being discharged typically has already been stabilized and may only need a final assessment before leaving, which can wait until after more critical assessments. Prioritizing clients based on urgency and stability is essential in nursing practice, and this case exemplifies that approach.