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[Expert Solution]: is 0700. You are assigned Mrs. Goldstein, a cl

is 0700. You are assigned Mrs. Goldstein, a client with COPD. In morning report, you learn that she was agitated during the night and is dyspneic this morning despite being started on O2 at 2L/nasal cannula at 0030. The 0600 vital signs are T 98.8F, P 102, RR 32, BP 146/98, Pain 4. The pulse oximeter reading was 89%. Mrs. Goldstein is receiving ipratropium bromide with albuterol (Duoneb) in nebulized inhalations every 4 hours and methylprednisolone (Solu-Medrol) 40 mg IV every 6 hours. Report is over and it is now 0730. 1. To best optimize the client’s respirations, prioritize the respiratory interventions in the sequence you would do them. State the evidence-based rationale for each intervention and why you placed the intervention in that particular order. Cite your source with page numbers. Respiratory Interventions Priority # Evidence-based Rationale for Action Auscultate lung sounds Assess functions of the pulse oximeter and O2 delivery system Retake the vital signs Interview patient Place in high-Fowler’s position and ask the client to cough Review latest physician notation Review home nebulizer use and maintenance 2. Two hours later, you assess Mrs. Goldstein. Which findings would be expected, and which findings would indicate worsening of her oxygenation? Hematocrit 38.2% Hemoglobin 10.5g/dL SpO2 98% Heart Rate 92 Respiratory Rate 24 4 second capillary refill time Lethargy Nonproductive cough Expiratory phase 3 times longer than inspiratory phase Increased shortness of breath with mild exertion Anxiety Restlessness WBCs 11.2 103/ mm3 Crackles, audible throughout the bilateral

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