Which patient should be seen first based on the latest vital signs?

• A. A 45-year-old client who is postoperative and has a BP of 130/82 mm Hg
• B. A 28-year-old client who runs marathons and has a heart rate of 54/min
• C. A 78-year-old client who has a temperature of 35.9° C (96.6° F)
• D. A 52-year-old client who has an SaO2 of 92%

Answer: (D)

Prioritize breathing and oxygenation. An oxygen saturation of 92% indicates hypoxemia, which can quickly impair tissue oxygen delivery and lead to organ dysfunction if not addressed. The immediate actions are to assess airway patency, assess breathing effort, and provide or adjust oxygen per protocol, then recheck SpO2 promptly.

The other patients show stable or less urgent concerns given their vitals in this moment: a postoperative blood pressure in the normal range, a very low heart rate in a well-trained athlete that can be normal, and a mildly low body temperature that, while worth monitoring, is less immediately threatening than insufficient oxygenation. If there are symptoms or a COPD baseline to consider, these would guide the exact steps, but the low SpO2 is the priority finding.