Which client should the nurse prioritize for a call back in a pulmonary clinic?

The client with a history of asthma and a peak flow of 45% of their personal best should be prioritized for a call back in a pulmonary clinic. This individual shows significant respiratory compromise, as a peak flow reading of 45% indicates severe airway obstruction. In asthma management, peak flow measurements are critical for assessing the patient's state in terms of their ability to breathe effectively. A reading below 50% of the personal best typically suggests the need for urgent medical attention, as this can lead to an increased risk of exacerbation or an asthma attack.

In contrast, while other options present concerning situations, they do not indicate a level of urgency that necessitates immediate return calls. The client with a pneumothorax who reports scant, clear drainage is stable enough to not require urgent intervention, as scant drainage does not imply acute respiratory distress. The client with active tuberculosis reporting dark red-orange urine could suggest medication effects, such as from rifampin, but this does not indicate an immediate threat to airway or respiratory status. Lastly, the client with COPD and an oxygen saturation of 90% is somewhat concerning, but oxygen saturation levels can vary in COPD patients, and a reading of 90% may not warrant an immediate call back if the patient is