A client with multiple sclerosis (MS) has a living will and a do not resuscitate (DNR) prescription in the medical record. Currently the client's oxygen saturation is 86% on room air and the client is anxious and requesting oxygen. Which intervention should the nurse implement first?

A. Administer a PRN IV sedative: While anxiety can worsen hypoxemia by increasing respiratory demand, administering a sedative before addressing oxygenation could depress respiratory effort and worsen hypoxia. Sedation should only be considered after ensuring adequate oxygenation and stabilizing the client’s respiratory status. B. Call the rapid response team: Activating the rapid response team may become necessary if the client’s condition deteriorates. However, immediate interventions that address the acute hypoxemia, such as oxygen administration, take priority over calling for assistance. Prompt oxygen therapy can quickly relieve hypoxia and associated anxiety. C. Review the DNR instructions for detailed actions: A DNR order indicates that cardiopulmonary resuscitation should not be performed in the event of cardiac or respiratory arrest. It does not prohibit interventions like supplemental oxygen or other measures to relieve hypoxemia. While reviewing the DNR is important for context, it is secondary to addressing the immediate oxygen deficit. D. Apply nonrebreather mask with 100% oxygen: The client’s oxygen saturation of 86% indicates significant hypoxemia requiring prompt correction. Applying a nonrebreather mask delivers high-concentration oxygen to quickly improve oxygen saturation. This intervention addresses the most immediate threat to the client’s safety while respecting the DNR status.