A client with a history of COPD

A client with a history of COPD presents to the emergency department with progressive shortness of breath and wheezing. The health care provider orders medications. The nurse assesses the client and documents in the nurses’ notes. The nurse then reviews the medication administration record. Nurses’ Notes 1910: Client reports worsening shortness of breath for the last 2 weeks, with even greater worsening over the past 3 days. Took home nebulizer treatments “just prior to coming” to the emergency department. Use of neck muscles to facilitate breathing. Lung sounds diminished to bases bilaterally with occasional scattered rhonchi. Sp02 85% on room air. Tachycardic with regular rhythm. O2 1L/NC applied. Reviewed MAR. Labs drawn and awaiting results. 2000: Client has noticeable tachypnea with accessory muscle usage. Pursed lip breathing. Audible crackles in the bilateral bases with wheezing in the remaining lung fields. Still waiting on lab results. Medication Administration Record Tiotropium 18 mcg inhaler, 1 puff daily Budesonide-formoterol 160-4.5 mcg/ACT inhaler 2 puffs 2 times daily Albuterol nebulizer 2.5 mg every 4 hours as needed for shortness of breath or wheezing Amlodipine 5 mg oral daily Oxygen 1-2 L/NC to maintain SpO2 greater than 88% 1. Which assessment finding(s) requires immediate intervention with albuterol nebulization? (Select all that apply). Shortness of breath Wheezing SpO2 85% Tachypnea Heart Rate 110 bpm 2. Provide a rationale to explain your answer choices. SCIENCE HEALTH SCIENCE NURSING RN 22

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