Which observation should the nurse address immediately?

The observation that should be addressed immediately involves the client who is crying and states "it hurts to take a deep breath or cough." This statement suggests that the client may be experiencing significant pain, which could indicate a serious underlying issue that requires prompt evaluation and intervention. The pain during deep breathing or coughing could be a sign of respiratory distress, potential pleurisy, or even a complication such as pneumonia or a pulmonary embolism.

It's crucial for nurses to prioritize symptoms that indicate potential respiratory complications or pain management needs, as these can quickly lead to more severe situations if not addressed. Ensuring the client's comfort and safety is paramount, especially if they are showing signs of distress. Immediate assessment and intervention, such as administering pain relief or assessing respiratory function, would likely be necessary to prevent further complications.

The other options, while important, do not indicate an immediate threat to the client’s health or safety. A request for water is a routine need, watching television indicates the client is stable and engaged, and a spouse expressing concern about medication side effects suggests a need for education rather than urgent care.