A newly admitted client with increasing dyspnea and dehydration has possible avian influenza (bird flu). Which action should you implement first?

• A. Start oxygen using a nonrebreather mask.
• B. Infuse 5% dextrose in water at 100 mL/hour.
• C. Administer first dose of oseltamivir (Tamiflu).
• D. Obtain blood and sputum specimens for testing.

Answer: (A)

When a newly admitted patient has increasing dyspnea and dehydration with suspected avian influenza, the most urgent need is to restore adequate oxygenation. Starting oxygen with a nonrebreather mask is the best first action because it delivers a very high concentration of oxygen quickly, addressing potential hypoxemia and reducing the work of breathing right away. Securing and improving breathing takes priority over other interventions, since turning around oxygen levels can prevent progression to respiratory failure.

After oxygen is initiated, further steps can follow as the patient is stabilized: obtaining blood and sputum for testing is important for diagnosis but does not treat the immediate threat of low oxygen; antiviral therapy should be started promptly but should not delay oxygen; and fluids for dehydration are important but should not replace or delay restoring adequate oxygenation. If oxygen needs remain high or SpO2 stays low, escalate respiratory support and reassess promptly.