Which client should be treated first according to the National Institutes of Health Stroke Scale (NIHSS)?

When considering the priority of treatment according to the National Institutes of Health Stroke Scale (NIHSS), a client with facial palsy should be treated first due to the significance of facial paralysis in assessing the severity and potential outcomes of a stroke. Facial weakness is one of the most visible indicators of a stroke and can often indicate a larger problem with brain function, particularly in areas that control facial muscles.

Facial palsy can significantly affect a patient's ability to communicate and may also be indicative of a higher chance of other complications. The NIHSS includes evaluation of facial palsy as a key component, and it is often one of the first signs noted in a neurological examination. Treating such a manifestation promptly can lead to more immediate interventions that may mitigate long-term effects and improve overall patient outcomes.

While arm weakness, speech difficulties, and leg weakness are all important symptoms to evaluate and manage, the presence of facial palsy often marks a more critical situation that may require urgent treatment decisions or interventions. Thus, prioritizing a patient exhibiting this symptom aligns with best practices in stroke management.