Day 4: RR 20 with pursed-lip breathing, SpO₂ 90% on 2 L within the 88–92% target, scattered wheeze improved from diffuse, sputum now scant clear, tolerating the bronchodilator and steroid taper. Skilled observation for a recurring exacerbation required; supports the Section O oxygen/treatment items.
Inhaler teaching to competence
MDI-with-spacer return-demo 5/5 (2nd attempt) after actuation-timing correction, action-plan teach-back 100%. Covered skilled teaching that reduces readmission; supports the respiratory goal.
Oxygen titration, stable
SpO₂ maintained at 89–91% within the ordered 88–92% target on 2 L, no accessory-muscle use, activity tolerated with energy conservation. Skilled titration and monitoring required; supports the Section O oxygen item.
