Client: Henry Lewis, 64, admitted with pneumonia and receivi…
Client: Henry Lewis, 64, admitted with pneumonia and receiving oxygen at 2 L/min via nasal cannula. During a respiratory assessment, the nurse notes: RR 22/min, shallow SpO₂ 92% on 2 L Crackles heard in both lower lobes Skin warm and dry Reports mild shortness of breath when walking to the bathroom While the nurse is listening to lung sounds, Henry begins coughing forcefully, becomes pale, and his SpO₂ drops to 84%. He states, “I can’t catch my breath.” Question: What should the nurse do first?
Read DetailsClient: Maria Thompson, 74 years old, admitted for pneumonia…
Client: Maria Thompson, 74 years old, admitted for pneumonia three days ago. When the nurse enters the room, Maria is sitting up in bed, eating breakfast. She says, “I just feel more tired today.” Assessment findings: Skin warm and slightly flushed Respirations 26/min, shallow Occasional cough producing thick yellow sputum Crackles heard in both lower lobes SpO₂ 90% on 2 L nasal cannula HR 110 bpm, BP 148/86 mmHg Fingers cool, capillary refill 5 seconds Reports shortness of breath when talking IV site is slightly red and tender Question: Which assessment findings should the nurse recognize as most concerning and requiring immediate follow-up? Select all that apply.
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