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A client who has chronic obstructive pulmonary disease (COPD) is resting in a semi-Fowler's position with oxygen at 2 L/min per nasal cannula. The client develops dyspnea. Which action should the nurse take first?

A. Call the HCP
B. Obtain a bedside pulse oximeter
C. Raise the head of the bed higher
D. Assess the clients vital signs

User A Srinivas
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1 Answer

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Final answer:

The first action a nurse should take when a COPD client develops dyspnea is to assess the patient's vital signs, as they provide essential information on the client's respiratory and cardiovascular status. This will guide further immediate interventions.

Step-by-step explanation:

When a client with chronic obstructive pulmonary disease (COPD) develops dyspnea, the first action a nurse should take is to assess the client's vital signs. This is crucial because vital signs, including heart rate, respiratory rate, blood pressure, and oxygen saturation (SpO2), provide important information about the client's respiratory and cardiovascular status. By assessing these, a nurse can determine the severity of the dyspnea and whether the client's condition is worsening.

In the scenario of a COPD patient developing dyspnea while receiving oxygen therapy, monitoring vital signs could indicate if the client is experiencing hypoxemia, which means a lower-than-normal level of oxygen in the blood, a common complication in COPD. It would also reveal if there are any changes in heart rate, which could signify compensatory mechanisms in response to poor oxygenation. The findings will guide the nurse in deciding further interventions, such as adjusting the flow of oxygen or alerting the healthcare team for potential escalation of care.

User Heyman
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