Which is the first priority for a nurse monitoring a client receiving chemotherapy for potential side effects?

The primary focus for a nurse monitoring a client receiving chemotherapy is to identify and manage potential side effects of the treatment, particularly those that are acutely life-threatening. In this case, checking lung sounds for crackles is crucial because many chemotherapy agents can lead to pulmonary complications, such as lung infections or pneumonitis, which can present with crackling sounds in the lungs due to fluid accumulation. Identifying these early allows for timely intervention, which can significantly improve the patient's outcome.

Monitoring signs of respiratory distress is essential since such complications may escalate quickly if not addressed. Therefore, regularly assessing lung sounds is a proactive measure in managing the patient's health during chemotherapy.

Other aspects, such as assessing blood pressure, monitoring intake and output, and evaluating skin integrity, are also important in a comprehensive nursing assessment but may not be as immediately urgent in the context of the dangerous side effects associated with chemotherapy. While BP monitoring is crucial for tracking cardiovascular status, and intake/output monitoring is vital for fluid balance, they do not specifically target the acute respiratory concerns that can arise from chemotherapy treatments. Likewise, skin integrity checks are important for assessing side effects like rashes or sores but may not pose an immediate threat to life or require urgent intervention compared to potential pulmonary complications.