What should be the priority nursing action when caring for a client with a possible ectopic pregnancy?

In the context of caring for a client with a possible ectopic pregnancy, monitoring the apical pulse is particularly critical due to the risk of internal bleeding associated with ectopic pregnancies. This condition often leads to significant complications if the pregnancy is not identified and managed promptly. Internal bleeding from a ruptured ectopic implantation can result in hypovolemic shock, characterized by a drop in blood pressure, increase in heart rate, and changes in the patient's level of consciousness.

By monitoring the apical pulse, the nurse can quickly assess for tachycardia, which may indicate the body’s response to hypovolemia or stress. Early detection of changes in cardiovascular status allows for timely interventions to stabilize the patient, including notifying the healthcare provider and preparing for potential emergent interventions.

Other actions, while important, follow in urgency after ensuring that the patient's cardiovascular status is stable. For example, preparing for surgery is only necessary if it is determined that surgical intervention is required, while signs of infection and collecting urine for a pregnancy test are less immediate in terms of life-threatening conditions. Therefore, the priority nursing action is to closely monitor the apical pulse to detect any signs of compromised health swiftly.