The unlicensed assistive personnel (UAP) reports to the regi…

The unlicensed assistive personnel (UAP) reports to the registered nurse that a client admitted with pneumonia is very diaphoretic. The nurse reviews the following vital signs in the chart obtained by the UAP.  The nurse should do which of the following? (Select all that apply) Time 0800 1000 1200 Temp 100.9   101.8 Pulse 90 104 118 Resp 16 18 24 BP 112/74 110/68 96/64 SpO2 93% 92% 92%