The nurse is assessing a client with a diagnosis of acute emphysema. The client is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which assessment findings should be reported to the provider immediately?

Choice A reason: A client who had open reduction and internal fixation of a femur fracture 3 days ago is likely to need ongoing monitoring and care to ensure proper healing and prevent complications. Discharging this client could risk worsening their condition or causing new issues to arise.

Choice B reason: A client admitted last night with community-acquired pneumonia is still in the early stages of treatment and may require close observation and medication adjustments to effectively manage their condition and prevent deterioration.

Choice C reason: An older adult client in the observation unit for evaluation of chest pain may still be at risk for serious conditions such as a heart attack. Releasing this client without a definitive diagnosis or proper management plan could endanger their health.

Choice D reason: A client on the medical unit for wound care for a stage 2 wound to the lower extremity is generally considered stable and appropriate for discharge, provided they have the necessary support and resources to continue wound care at home. This client does not require intensive monitoring or treatment that would necessitate hospital admission.

Choice A reason: A heart rate of 104 bpm can be expected in a client with pneumonia and after suctioning. Tachycardia (elevated heart rate) can occur as a response to infection, stress, or the suctioning procedure itself. While it should be monitored, it is not the most critical finding.

Choice B reason: A tympanic temperature of 102.6°F (39.2°C) is unexpected and indicates a significant fever, which may suggest a worsening infection or sepsis. This finding requires immediate attention as it could indicate that the current treatment for pneumonia is not effective, and the client's condition may be deteriorating.

Choice C reason: A blood pressure of 158/90 mmHg, though elevated, may be less critical in the context of this client's condition. Hypertension can occur due to various factors, including stress and illness, and should be monitored but is not the most urgent priority compared to a high fever.

Choice D reason: A respiratory rate of 24 breaths/min is slightly elevated but can be expected in a client with pneumonia and after suctioning. This rate indicates mild tachypnea, which should be monitored but is not as immediately concerning as a high fever.