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When a client presents with status asthmaticus, what position should the nurse place them in initially?

  1. Supine position

  2. High-Fowler's position

  3. Left lateral position

  4. Trendelenburg position

The correct answer is: High-Fowler's position

High-Fowler's position is the optimal initial position for a client experiencing status asthmaticus. By elevating the head of the bed to a 60-90 degree angle, this position facilitates easier breathing and maximizes lung expansion. It allows for the diaphragm to have more space to move and decreases the work of breathing by enhancing the mechanics of ventilation. This is particularly important in cases of severe asthma exacerbations where airway obstruction and difficulty in breathing are prominent. Placing the client in a supine position could exacerbate their breathing difficulties because it may compress the diaphragm and increase the work required for respiration. The left lateral position, while sometimes beneficial in different medical contexts, does not provide the same respiratory advantages as High-Fowler's position in cases of severe bronchospasm. Trendelenburg position, which involves tilting the body so that the head is lower than the feet, is not appropriate for respiratory distress as it can lead to increased abdominal pressure on the diaphragm, further hindering effective lung function.