# A client with asthma reports increasing shortness of breath and wheezing. The oxygen saturation is 90% on room air. Which nursing actions are appropriate? Select all that apply.

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> subject: Medical Emergencies  
> category: PA

## Question

A client with asthma reports increasing shortness of breath and wheezing. The oxygen saturation is 90% on room air. Which nursing actions are appropriate? Select all that apply.

1

Assess breath sounds, work of breathing, and response to therapy.

2

Encourage hallway ambulation to loosen secretions.

3

Offer oral fluids as the only intervention and reassess later.

4

Apply oxygen as prescribed to improve oxygenation.

5

Place the client in high-Fowler's position.

6

Administer the prescribed short-acting bronchodilator.

## Explanation

Acute asthma symptoms with low oxygen saturation require airway-focused positioning, prescribed quick-relief bronchodilator therapy, oxygen as indicated, and close reassessment of respiratory status. Ambulation can worsen distress during an acute exacerbation. Oral fluids alone do not address bronchospasm or impaired oxygenation.

## In-depth explanation

Clinical Judgment
For acute wheezing with hypoxemia, support ventilation first and give ordered quick-relief therapy while reassessing response.

Memory Tip
Sit up, bronchodilate, oxygenate, reassess.

KR vs US
NCLEX asthma questions prioritize immediate airway and breathing interventions over routine comfort measures.

## Clinical scenario

Clinical Practice Guide
NHLBI asthma guidance describes quick-relief medicines, nebulized therapy, oxygen therapy, and urgent care for serious attacks that do not improve promptly.

Caution
A quiet chest, fatigue, decreasing level of consciousness, or persistent hypoxemia is an emergency.

## Key concepts

- **Bronchospasm** — Narrowing of airway smooth muscle that increases work of breathing and causes wheezing.
- **Short-Acting Bronchodilator** — A quick-relief medication used to relax airway smooth muscle during acute symptoms.
- **Hypoxemia** — Lower-than-expected oxygen level in the blood, often reflected by low oxygen saturation.

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