Severe Asthma Attack
A 24-year-old client with a history of asthma comes to the clinic reporting three days of worsening wheezing and night-time coughing. The client has been using a rescue inhaler every two hours.
Recognize cues
Vital signs: BP 128/76, HR 122, RR 32, SpO2 89% on room air, temperature 36.9 C. The client speaks in three-word phrases, uses neck and intercostal muscles to breathe, and the chest is nearly silent on auscultation.
Which finding requires the most immediate follow-up?
Take action
The provider orders albuterol by nebulizer, oxygen to keep SpO2 above 92%, IV methylprednisolone, and a peak flow measurement.
Which two actions should the nurse take first?
Evaluate outcomes
Twenty minutes later the client speaks in full sentences. Vital signs: HR 96, RR 20, SpO2 95% on 2 L/min. Scattered expiratory wheezes are now audible throughout both lung fields.
Which finding best indicates the treatment is working?
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