A patient has been admitted to a medical-surgical unit with…
Questions
A pаtient hаs been аdmitted tо a medical-surgical unit with cоmplaints оf shortness of breath and a diagnosis of acute hypoxic respiratory failure secondary to pneumonia. Vital signs are below. Upon assessment, the nurse finds course crackles in all lung lobes with diminished lung sounds in the bases. Patient denies pain, but states: "I just can't catch my breath." HR BP RR SpO2 Temperature 94 144/85 26 90%(6 liters, nasal cannula) 37.6 degrees C Physician Orders General:Utilize an appropriate oxygen delivery device to maintain SpO2 greater than 94%Notify physician if O2 saturation < 90% or respiratory rate > 30/minIncentive spirometry every hour while awakeElevate the head of the bed 30–45 degrees Lab:Arterial Blood Gases (ABG) every 6 hours and PRN for respiratory status changesCBC with differential dailyBasic Metabolic Panel (BMP) dailySputum culture and sensitivity x 1 STATChest X-ray in 48 hours to assess for resolution or progression Medications:IV 0.9% Normal Saline at 75 mL/hrAzithromycin 500 mg IV once dailyAcetaminophen 650 mg PO every 4-6 hours PRN for fever > 38°CMorphine 2 mg IV every 2 hours PRN for severe dyspnea or pain (monitor respiratory status closely)Enoxaparin 40 mg SC daily (if no contraindications) The nurse raises the head of bed to semi-fowler's position. What physician order should the nurse implement next?