The nurse is caring for a client. Which of the following actions should the nurse take? Select all that apply.

Rationale: A. The client shows signs of acute deterioration (tachypnea, hypoxia, distress, chest discomfort). Activating the rapid response team ensures immediate multidisciplinary intervention to prevent further decline. B. Fondaparinux is an anticoagulant used to treat and prevent thromboembolic events such as pulmonary embolism. Given the high suspicion for PE following hip surgery, anticoagulation is an appropriate anticipated intervention. C. Midazolam is a sedative and can depress respiratory drive. In a client with respiratory distress and hypoxia, sedation can worsen the condition and is not appropriate unless the client requires intubation or procedural sedation under close monitoring. D. Chest tube insertion is indicated for conditions such as pneumothorax or pleural effusion, not pulmonary embolism. There is no evidence suggesting a collapsed lung or fluid accumulation requiring drainage. E. The client may require rapid administration of medications (e.g., anticoagulants), fluids, or emergency drugs. Ensuring patent IV access is critical in managing acute deterioration. F. High-Fowler’s position promotes lung expansion, improves oxygenation, and helps reduce the work of breathing in clients experiencing respiratory distress.