The nurse has received report on four patients at 0700. Which patient should the nurse assess first?

The nurse is caring for a patient on the night shift in respiratory distress due to influenza. Over the last few hours, the patient has become increasingly confused, perfusion has decreased, and urine output has fallen to zero. The nurse contacts the resident physician to come assess the patient and requests an order for transfer to the intensive care unit. The physician orders the nurse to administer 1L 0.9% NaCl via IV infusion. One hour after the infusion is complete, the patient has made no improvement. What is the nurse’s next action?

The patient tells the nurse, “When is Sally working again? She has been my favorite nurse so far.” Which response by the nurse is appropriate?