Upon reporting to work and receiving report, a nurse has been assigned to provide care for three clients. Each of the clients has called out to the nurses' station requesting assistance. Which client should the nurse see first?

A. Administration of oral and IV corticosteroids as prescribed: Corticosteroids may reduce inflammation but are not the primary treatment in septic arthritis and may even suppress immune response. Antibiotic therapy must be initiated first to control the infection.

B. Prevention of falls and pathologic fractures: While fall prevention is always important, it is not the most urgent need in the acute management of septic arthritis. The priority is treating the infection promptly to prevent joint destruction and systemic spread.

C. Maintenance of adequate serum levels of vitamin D: Vitamin D plays a role in bone health, but this is a long-term concern and does not directly impact the acute treatment of joint infection. It is not relevant to the immediate plan of care for septic arthritis.

D. Intravenous administration of antibiotics: Septic arthritis is a serious joint infection that requires rapid IV antibiotic administration to eradicate the pathogen, prevent sepsis, and preserve joint function. It is the most critical and time-sensitive intervention.

A. Check the drainage for glucose: Clear nasal drainage after transsphenoidal surgery may indicate a cerebrospinal fluid (CSF) leak. The nurse should immediately test the drainage for glucose, as CSF contains glucose and nasal secretions do not. This helps confirm the presence of a CSF leak, a potential serious complication.

B. Obtain a culture of the drainage: Culturing the drainage may be necessary if infection is suspected, but it is not the priority. Identifying whether the fluid is CSF takes precedence, as it may require urgent surgical intervention to prevent complications such as meningitis.

C. Notify the client's provider: While the provider should be notified promptly after confirming suspicion of a CSF leak, the nurse’s first step should be to assess the nature of the drainage. Providing objective data supports effective and timely communication.

D. Document the amount of drainage: Documentation is important, but it does not address the potential risk of a CSF leak. Before recording findings, the nurse should investigate the nature of the fluid to ensure appropriate clinical action is initiated.