Which client should the night nurse assess first based on their symptoms?

The priority in nursing assessment often hinges on the potential for life-threatening conditions as well as the urgency of intervention needed. In this scenario, the client with a spinal cord injury reporting a throbbing headache should be assessed first because headaches in this population can signal serious complications, such as autonomic dysreflexia.

Autonomic dysreflexia is a medical emergency characterized by a sudden onset of excessively high blood pressure and other symptoms, which can be triggered by a noxious stimulus below the level of injury. This condition can lead to severe complications, including risk of stroke or death if not addressed promptly. The throbbing nature of the headache might indicate increased intracranial pressure or complications related to the spinal injury, thus necessitating immediate evaluation and intervention.

While the other clients have significant health concerns that require attention, they do not present the same level of immediate risk associated with the symptoms. The acute kidney injury and the client with bladder spasms post-prostatectomy are concerning, but they do not carry the acute, life-threatening urgency that the client with a spinal cord injury does. The client with the ureteral stent also has concerning symptoms, but again, these are not as critical as those indicative of a possible autonomic dysref