The office nurse receives 4 telephone messages. Which client should the nurse call back first?

1. 28-year-old female client who fell on ice yesterday and has low back pain and spasm.
2. 42-year-old male client who developed sharp, burning leg pain radiating from buttock to knee after lifting heavy weights.
3. 65-year-old female client 10 days post spinal fusion who has increased persistent back pain and fever of 101.2 F (38.4 C).
4. 70-year-old male client with peripheral vascular disease who has acute-onset abdominal pain radiating to the low back.

The nurse should call back the 65-year-old female client 10 days post spinal fusion who has increased persistent back pain and a fever of 101.2 F (38.4 C) first. This patient has recently undergone spinal fusion surgery and is now experiencing increased back pain and fever, which could indicate an infection or other complications related to the surgery. Immediate medical attention is required to assess and treat any potential issues.

The nurse should call back the 70-year-old male client with peripheral vascular disease who has acute-onset abdominal pain radiating to the low back (Option 4) first. This client's symptoms are concerning for a potential abdominal or vascular emergency, such as an abdominal aortic aneurysm, which is a life-threatening condition. Prompt assessment and intervention are crucial in such cases to prevent complications. While the other clients also have important concerns, this client's symptoms indicate a higher level of urgency, and immediate attention is needed to evaluate and address the abdominal pain and its potential vascular implications.

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