A nurse is preparing to transfer a client from the emergency department to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the background portion of the report?

Choice A reason: The charge nurse should address the situation of the emergency department nurse waiting to give report on a new admission first. This is the most urgent and time-sensitive issue that affects the client's safety and continuity of care. The charge nurse should assign a staff nurse to receive the report and prepare for the admission.

Choice B reason: The charge nurse should address the situation of a nurse on the previous shift writing an incident report about a medication error second. This is an important and serious issue that requires follow-up and corrective actions. The charge nurse should review the incident report, talk to the nurse involved, and implement measures to prevent future errors.

Choice C reason: The charge nurse should address the situation of two staff members calling to say they will be absent third. This is a significant and challenging issue that affects the staffing and workload of the unit. The charge nurse should contact the staffing office, request replacements, and adjust the assignments accordingly.

Choice D reason: The charge nurse should address the situation of transport assistance being unavailable to take a client to occupational therapy last. This is a minor and temporary issue that does not compromise the client's health or well-being. The charge nurse should contact the transport department, reschedule the therapy session, and inform the client and the therapist.

Choice A reason: A client who has a compromised airway is in immediate danger of death and requires urgent attention. A red tag indicates that the client has a life-threatening condition and needs the highest priority of care.

Choice B reason: A client who has major burns covering 70% of their body is in critical condition and needs intensive care. However, they are not as urgent as a client who has a compromised airway. A yellow tag indicates that the client has a serious condition and needs the second highest priority of care.

Choice C reason: A client who experienced a brief loss of consciousness may have a concussion or a head injury, but they are not in immediate danger of death. A green tag indicates that the client has a minor condition and needs the lowest priority of care.

Choice D reason: A client who has fixed pupils is likely dead or near death and has no chance of survival. A black tag indicates that the client is deceased or expectant and needs no care.