The nurse is working triage in the ED when four clients present at the same time. Which client should be seen first ?

  • a 45-year-old female on oral contraceptives with unusually heavy menstrual bleeding
  • a 24-year-old with a dog bite to the leg from the family dog who is current on rabies shots
  • an irritable 4-month-old with a petechial rash, nuchal rigidity, and temperature of 103.4°F
  • a 16-year-old football player with a twisted ankle who has no deformity and a pedal pulse
Number 3 is correct.
Petechial rash, nuchal rigidity, and fever are signs of meningitis, which is a medical emergency, especially in an infant. The client with heavy menstrual bleeding is not as urgent as the infant. Dog bites from a known pet current on rabies shots are less urgent than bites from a dog with an unknown rabies status. A twisted ankle with a pedal pulse and no deformity is not life-threatening and can be seen after more urgent clients.