Which client should be prioritized for assessment by the nurse in the emergency department?

The prioritization of clients in an emergency department setting is guided by the principle of assessing those who present with the most critical and life-threatening conditions first. In this scenario, the 14-year-old who is lethargic and presents with a high fever of 104.1°F is the most concerning.

Lethargy in a pediatric patient can indicate a significant underlying issue, such as an infection or other systemic illness that could lead to serious complications. The elevated temperature suggests a possible severe infection, which warrants immediate evaluation and intervention. High fever combined with lethargy can reflect conditions such as meningitis or serious infections that require urgent treatment to prevent deterioration.

In contrast, the other clients, while needing assessment, do not demonstrate immediate risk factors that indicate they require prioritization over the lethargic teenager. For instance, though a heart rate of 124 beats per minute in a 5-year-old may be elevated, it is not as urgent compared to the lethargy and high fever in the 14-year-old. The 7-year-old with vaginal lacerations and bruising raises concerns for possible abuse but does not indicate acute medical distress that demands immediate action. Lastly, the 10-year-old with a draining abscess requires attention