You are caring for OJ, 77 years old, female and was admitted to the medical unit with exacerbation of COPD. Vital signs upon admission to the unit is: Blood Pressure 156/88, Pulse 101; Respiratory Rate 28, Temperature 97.8°F. The client reports worsening shortness of breath, extreme fatigue, decreased appetite, and a weight loss of 15 pounds over the past three months. You notice the patient is lying flat in bed and currently on 2L O2 via nasal canula with an oxygen saturation level of 88%. Other symptoms include a dry cough, inspiratory and expiratory wheezes upon auscultation of breath sounds. Respiratory treatments (albuterol) are ordered every 4 hours as needed. The patient reports having little or no family support.