Problem: The client was admitted to the medical-surgical unit for COPD exacerbation. The client states they have become progressively short of breath over the last week and says, "I wasn't able to breathe, and I was so tired." The client is short of breath, chest is barreled, and they are wheezing in lungs bilaterally. They deny sputum production. S1, S2 heart sounds heard with no murmur. Their skin is dry, clubbing of fingernails. The client denies fever.