The nurse is completing the admission assessment of a client with multiple sclerosis (MS). Which finding(s) should be reported to the healthcare provider immediately? Select all that apply.

Choice A reason: The healthcare power of attorney is important but not the first piece of information to report in this acute situation.

Choice B reason: The reason for admission provides context but is secondary to the current critical issue.

Choice C reason: Increasing confusion is the immediate concern that needs to be addressed first in the SBAR report.

Choice D reason: Currently prescribed medications are relevant but come after addressing the acute change in the client's condition.

Choice A reason: Intubation is not the first step in managing COPD exacerbation unless the client is in severe respiratory failure (e.g., unresponsive, unable to protect airway, pH severely low). This client is alert, able to maintain vitals, so less invasive interventions should be tried first.

Choice B reason: High-flow oxygen at 100% can eliminate the hypoxic drive to breathe in COPD patients, leading to CO₂ retention and respiratory acidosis. Controlled oxygen therapy (e.g., nasal cannula or Venturi mask at 1–2 L/min or FiO₂ 24–28%) is preferred.

Choice C reason: This "tripod" position reduces work of breathing by optimizing diaphragmatic expansion and helping accessory muscles function more effectively. It is an evidence-based immediate nursing intervention for acute dyspnea in COPD.

Choice D reason: Obtaining a sputum sample for culture and sensitivity is important for identifying the cause of the infection but is not the immediate priority.