A nurse is caring for a client who has meningitis. Which of the following assessments should the nurse perform?

A. A barrel chest: A barrel-shaped chest is a common structural change in clients with long-standing COPD. While it reflects chronic disease, it is not an acute change requiring immediate provider notification.

B. Coughing and wheezing after eating: This may indicate mild aspiration or gastroesophageal reflux, which should be monitored and addressed, but it is not immediately life-threatening if the client remains stable.

C. Abdominal bloating: Abdominal bloating can occur due to air swallowing or gastrointestinal changes in COPD, but it is not an urgent concern unless accompanied by severe pain, distention, or other acute symptoms.

D. A drop in oxygen saturation to 91% while eating: A sudden decrease in oxygen saturation indicates hypoxemia and potential respiratory compromise, especially in a client with COPD. This acute change requires immediate provider notification and possible intervention, making it the highest priority finding.

A. Heart rate 56/min: Bradycardia is not typical during severe alcohol withdrawal. Instead, clients often exhibit tachycardia due to autonomic hyperactivity and increased sympathetic nervous system stimulation.

B. Dry skin: While skin changes can occur, dry skin is not a hallmark of alcohol withdrawal. Other findings such as diaphoresis, tremors, and pallor are more commonly observed.

C. Temperature 38.6°C (101.5°F): Fever is a common sign of severe alcohol withdrawal, reflecting the hypermetabolic state and autonomic hyperactivity associated with withdrawal. Elevated temperature, along with tachycardia, hypertension, and diaphoresis, indicates a more severe withdrawal process that requires close monitoring and intervention.

D. Drowsiness: Severe alcohol withdrawal typically presents with hyperalertness, agitation, and insomnia rather than drowsiness. Lethargy may suggest other complications, but it is not a typical manifestation of acute withdrawal.