When Every Breath Becomes a Struggle: Respiratory Failure in the ER” A 68-year-old male arrives at the emergency department with severe shortness of breath. He has a history of COPD and reports increasing difficulty breathing over the past 3 days. Assessment Findings: * Respiratory Rate: 32 breaths/min * Heart Rate: 118 bpm * Blood Pressure: 154/88 mmHg * SpO₂: 82% on room air * Uses accessory muscles to breathe * Unable to speak full sentences * Skin appears pale and slightly cyanotic around the lips * Lung sounds: diminished with wheezing bilaterally ABG Results: * pH: 7.28 * PaCO₂: 60 mmHg * PaO₂: 55 mmHg * HCO₃⁻: 28 mEq/L Nursing Priorities: 1. Assess airway, breathing, and circulation (ABCs). 2. Apply oxygen as prescribed and monitor SpO₂. 3. Position patient in High Fowler’s position. 4. Notify the physician/respiratory therapist immediately. 5. Prepare for BiPAP or possible intubation if condition worsens. 6. Administer prescribed bronchodilators and corticosteroids. 7. Monitor vital signs and respiratory status closely. Outcome: After initiation of BiPAP, bronchodilators, and oxygen therapy, the patient’s oxygen saturation improves to 92%, respiratory distress decreases, and he is admitted to the ICU for further monitoring. 🌐 Learn More: nursehubglobal.com - @globalnursehu