A nurse is assisting with the care of a client who has pneumonia. Which of the following actions should the nurse take? (Select all that apply.)

This scenario requires selecting appropriate nursing interventions for a client with pneumonia to improve oxygenation and clear secretions. Knowledge of respiratory mechanics, fluid dynamics, pulmonary hygiene protocols, and normal physiological oxygen saturation targets must be applied to select the correct actions. Choice A rationale Clients with pneumonia should be instructed to perform deep breathing and coughing exercises every 1 to 2 hours while awake. Hourly single coughs are insufficient to clear thick pulmonary secretions from the lower respiratory tract effectively. Choice B rationale Placing the client in an upright sitting position, such as High-Fowler's, maximizes diaphragmatic excursion and chest expansion. This position decreases the work of breathing, optimizes lung volumes, and enhances ventilation-perfusion matching to improve oxygenation. Choice C rationale Promoting a daily fluid intake between 2500 mL and 3000 mL thin out tenacious respiratory secretions. Hydration facilitates productive coughing and expectoration of sputum by reducing the viscosity of mucus in the alveolar and bronchial spaces. Choice D rationale The incentive spirometer should be used frequently, typically 5 to 10 times every 1 to 2 hours while awake, to prevent atelectasis. Encouraging use only every 6 hours is insufficient to maintain alveolar recruitment. Choice E rationale Maintaining oxygen saturation at 86 percent is inadequate and indicates severe hypoxemia. The target peripheral oxygen saturation for a standard pneumonia patient should be maintained within the normal range of 92 percent to 100 percent.