The nurse observes that a client with ascites is dyspneic. Which action should the nurse implement first?
Explanation & Rationale
A. While measuring vital signs is important, it does not directly address the client's immediate difficulty in breathing. Prioritizing the client's comfort and respiratory function is more critical in this situation. B. Assisting the client to a high Fowler's position helps facilitate lung expansion and may alleviate dyspnea. This position can improve respiratory function by reducing abdominal pressure on the diaphragm. C. Deep breathing exercises are beneficial but are not the immediate priority; positioning the client for better airflow should come first. D. Auscultating breath sounds is necessary for assessing the underlying cause of dyspnea, but this should be done after ensuring the client is in a position that maximizes their breathing capacity.