Question

A nurse is reviewing prescriptions for a client who has acute dyspnea and diaphoresis. The client states she is anxious and is unable to get enough air. Vital signs are HR 117/min, respirations 38/min, temperature 38.4 C (101.2 F), and blood pressure 100/54 mm Hg. Which of the following nursing actions is the priority?

A. Notify the provider.
B. Administer heparin via IV infusion.
C. Administer oxygen therapy.
D. Obtain a spiral CT scan.

Answer 1

The priority nursing action for a client experiencing acute dyspnea, diaphoresis, and anxiety is to administer oxygen therapy.

Step-by-step explanation:

The priority nursing action for a client who is experiencing acute dyspnea, diaphoresis, and anxiety is to administer oxygen therapy. These symptoms, along with vital signs such as increased heart rate, respiratory rate, and fever, suggest a potential respiratory problem, such as pneumonia. Oxygen therapy can help improve oxygenation and relieve the client's dyspnea. While notifying the provider and conducting further tests may be necessary, administering oxygen therapy is the immediate priority to address the client's respiratory distress.