What should the nurse implement first for a client who is 2 days postoperative for a left pneumonectomy with an apical pulse of 128 and blood pressure of 80/50?

In this situation, the client is presenting with signs of potential hypovolemia or inadequate perfusion, as indicated by an elevated heart rate (tachycardia) and a low blood pressure (hypotension). The first action a nurse should take is to increase the client's intravenous (IV) fluid rate.

Administering IV fluids can help improve blood volume and, subsequently, blood pressure, which is essential in stabilizing the patient. Flushing the system with fluids not only supports circulating volume but also addresses the urgency of the hypotensive condition. By increasing the IV rate, the nurse can provide immediate support as other interventions are considered.

After addressing the fluid needs, other actions such as notifying the healthcare provider (HCP), assessing the wound for complications, or preparing to administer medication may be necessary but should be prioritized after ensuring adequate vascular volume has been restored. The quick response of increasing IV fluids can be critical in preventing further complications and stabilizing the patient's condition.