A nurse is assisting in the care of an older adult client who was admitted from a long-term care facility. Exhibits Select the 3 findings that require immediate follow-up.

A. Current level of consciousness. Changes in mental status, such as confusion or decreased alertness, can indicate hypoxia, infection, or worsening respiratory distress. Given the client’s history and symptoms, altered consciousness requires immediate follow-up to assess for possible hypoxemia or sepsis. B. Heart rate. While the heart rate of 104/min is slightly elevated, it is not critically abnormal. Tachycardia can occur due to fever, anxiety, or respiratory distress, but it is not the most urgent concern compared to other findings. C. Respiratory rate. The client’s respiratory rate of 30/min is significantly elevated, indicating possible respiratory distress. Increased work of breathing suggests inadequate oxygenation or potential pneumonia, requiring immediate evaluation and intervention. D. Chronic health condition. The client has Parkinson’s disease and a history of smoking, both of which are important considerations in their overall care but do not require immediate intervention in the current scenario. E. Tremors. Tremors are a common symptom of Parkinson’s disease and do not indicate an acute emergency. They do not require urgent follow-up in this case. F. Oxygen saturation level. An oxygen saturation of 89% on room air is concerning, as it indicates hypoxemia. Immediate intervention, such as supplemental oxygen and further respiratory assessment, is necessary to prevent further deterioration.