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A 34-year-old woman with a history of bipolar disorder and an allergy to tree nuts. The client has experienced one hypersensitivity reaction as a child. However, as an adult she is careful to avoid ingestion of tree nuts and thought the sensitivity went away. She was unaware that the new dish at the restaurant had crushed cashews in the sauce. This evening patient was eating at a local restaurant. After eating several bites of a new dish, she began to experience itching and tightness in the back of her throat. Lips became red and edematous. The client described difficulty breathing and EMS notified. Emergency services arrived within 6 minutes. The client was hypoxic but awake on their arrival. The client received oxygen at 8 L per nasal cannula and 0.3 mg of epinephrine intramuscularly and a bolus of normal saline intravenously in route to the hospital. Current assessment reveals stridor with decreased breath sounds, laryngeal edema, facial swelling, and a decreased level of consciousness. Currently in sinus tachycardia with heart rate varied from 120 to 150 beats/min. Current blood pressure is 90/40 mm Hg after a normal saline fluid bolus in route to the hospital. The client’s spouse is present and reports occasional alcohol use and no illicit drug use. The client takes lithium 600 mg per day. She also takes cetirizine 10 mg daily. Temperature: 98.6°F (37°C) Blood pressure: 90/40 mm Hg Heart rate: 140 beats/min Oxygen saturation: 86% on 15 L per face mask Current height: 5 feet, 4 inches (162.6 cm) Current weight: 140 pounds (63.5 kg) Body mass index: 24 kg/m2 Laboratory results Laboratory Parameter Result Reference Range Lithium level 1.0 mEq/L 0.8-1.2 mEq/L Fingerstick glucose 114 mg/dL 74-106 mg/dL (4.1-5.9 mmol/L) Blood type B+ Blood gases: Laboratory Parameter Result Reference Range pH 7.32 7.35-7.45 PaO2 71 mm Hg 80-100 mm Hg HCO3 29 mEq/L 21-28 mEq/L PaCO2 49 mm Hg 35-45 mm Hg SaO2 or SpO2 92% 95%-100% Orders continuous hemodynamic monitoring insert additional large-bore intravenous (IV) line administer IV normal saline 125 mL/h administer epinephrine 0.3 mg intramuscularly (IM) (second dose) laboratory tests: type and crossmatch, complete blood count (CBC), lithium level chest x-ray bedside glucose level electrocardiogram (ECG) arterial blood gas (ABG) Imaging studies Chest x-ray: no infiltrates; otherwise unremarkable ECG: sinus tachycardia The nurse analyzes all assessment data, including physical exam and laboratory results in the EHR to determine client problems and possible conditions. Which finding indicates that this client has a problem with oxygenation? Select all that apply Oxygen saturation 86% on 15 L of oxygen Blood pressure 90/40 mm Hg Heart rate 140 beats/min Body mass index 24 kg/m2 Continuous cardiac monitoring shows tachycardia Fingerstick glucose 114 mg/dl Lip swelling Arterial blood gas (ABG) values: pH 7.32; PaO2 71 mm Hg; HCO3 29 mEq/L; PaCO2 49 mm Hg; SpO2 9 The client reported feeling tightness in the back of her throat Decreased level of consciousness

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