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Considering the severity of anemia, the priority manifestation for the nurse to evaluate first should be the patient's symptoms related to cardiac function. The patient's hemoglobin level of 7.5 g/dL (78 g/L) is considered severe anemia, and with the reported increased heart rate of 105 bpm and palpitations, there is a high risk for cardiac distress. Additionally, the reticulocyte count indicates that the body is responding to the anemia by producing new red blood cells, however, as the anemia is severe, it is unable to compensate the oxygen demand.
Therefore, cardiac function should be closely monitored and evaluated, as severe anemia can cause the heart to work harder in order to pump enough oxygen to the body's tissues, potentially leading to cardiac distress or even heart failure. It is necessary to closely monitor vital signs, chest pain or discomfort, shortness of breath and any changes in the patient's cardiac status, as well as administering oxygen therapy as required. Also, close collaboration with the medical team is important to implement the correct treatment and ensure the patient's safety.