Which client should the nurse assess first based on their INR levels?

The focus on assessing the female client on warfarin with an INR of 7.5 is based on the critical importance of monitoring anticoagulation therapy and the risks associated with elevated INR levels. An INR (International Normalized Ratio) value above 3.0 typically indicates an increased risk of bleeding, and levels above 5.0 are considered dangerously high, requiring immediate medical attention. An INR of 7.5 signifies a significant risk of spontaneous bleeding, which could lead to serious and potentially life-threatening complications.

In this context, the urgency of the nurse's role is to assess the client with the elevated INR first to determine the need for interventions, such as administering vitamin K or potentially holding the dosage of warfarin, to prevent any adverse events. Consequently, prioritizing this client is paramount in ensuring patient safety and managing the risks associated with anticoagulation therapy.

The other clients mentioned may have various health concerns, but none present the same immediate risk for bleeding as indicated by the critically high INR level in the client on warfarin. Thus, the nurse's priority should be directed toward addressing the urgent need associated with that elevated INR.