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

The client experiencing intractable lower back pain and new urinary incontinence should be assessed first due to the concerning potential for a serious neurological condition, such as cauda equina syndrome or spinal cord compression. New urinary incontinence, especially in the context of back pain, raises red flags for possible damage to the nerve roots or the spinal cord that may require immediate medical intervention.

Urinary incontinence can indicate that the nerves controlling bladder function may be compromised, potentially leading to permanent damage if not addressed swiftly. Timely assessment is critical to prevent further complications or irreversible damage. While the other clients have significant symptoms, they do not present the same level of immediate risk to essential functions like bowel and bladder control does.