A nurse is caring for a 42-year-old client admitted with asthma exacerbation. The client reports increasing dyspnea, wheezing, and tightness in the chest. Respiratory rate is 28 breaths/min, oxygen saturation is 90% on room air, and peak expiratory flow rate (PEFR) is 40% of their personal best. The client has a standing order for a salbutamol nebulizer treatment every 4 hours as needed. Which nursing hypothesis should the nurse prioritize?

Question: A nurse is caring for a 42-year-old client admitted with asthma exacerbation. The client reports increasing dyspnea, wheezing, and tightness in the chest. Respiratory rate is 28 breaths/min, oxygen saturation is 90% on room air, and peak expiratory flow rate (PEFR) is 40% of their personal best. The client has a standing order for a salbutamol nebulizer treatment every 4 hours as needed. Which nursing hypothesis should the nurse prioritize?

Answer options:

• The client is experiencing an allergic reaction that is worsening the asthma. ✅ The client's asthma exacerbation is progressing and requires immediate bronchodilator therapy.
• The client is anxious, and this is contributing to their perception of dyspnea.
• The client has developed a respiratory infection, indicated by the decreased PEFR.

Correct answer: The client's asthma exacerbation is progressing and requires immediate bronchodilator therapy.

Explanation: Prioritizing hypotheses involves ranking the possible reasons for the client's condition based on the immediacy and severity of the threat. Acute asthma symptoms with decreased oxygen saturation and PEFR indicate a significant respiratory compromise requiring immediate bronchodilator intervention before other less urgent possibilities.