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Problem
About two hours after you last checked on Mr. Brady, you notice that his skin has become cool and clammy. He is breathing heavily and labored, and his respiratory rate is 44 bpm. He appears to be gasping for air and is diaphoretic. You notice some jugular venous distension and his lung sounds are bilateral crackles and expiratory wheezing. He is now complaining of worsening abdominal pain. His current VS are as follows: BP=185/100, HR= 133 bpm, RR= 44 bpm, SPO2= 88% on RA. His urine output is 25ml/hr since admission. What nursing intervention should you (as the nurse) perform right away? The most critical intervention for Mr. Brady at this time would be to administer supplemental oxygen to improve his oxygen saturation, given that his SpO2 is at 88% on room air (RA). Additionally, placing the patient in a high Fowler's position can help ease his respiratory distress. Get the instant assignment help. What is your initial impression in a physiological sense of what is happening with Mr. Brady? Given the signs and symptoms, Mr. Brady likely is experiencing acute failure with pulmonary edema. The crackles and wheezing in his lungs suggest fluid accumulation due to congestive heart failure, resulting in impaired gas.
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