A nurse is caring for a client with COPD who missed their flu and pneumonia vaccinations. What vital sign warrants immediate attention?

A vital sign that warrants immediate attention in a client with COPD who has missed flu and pneumonia vaccinations is an oral temperature of 101.4°F. This elevated temperature indicates a potential fever, which may suggest an underlying infection. In patients with COPD, even minor respiratory infections can exacerbate their condition, leading to increased respiratory distress, decreased oxygenation, and potential hospitalization.

Monitoring for signs of infection is critical in this population, as they are already at a heightened risk for respiratory complications. Elevated temperatures can lead to increased metabolic demand and further strain on the respiratory system, making prompt evaluation and intervention vital.

Other vital signs, while relevant, do not indicate an immediate threat when considered in isolation. For example, a respiratory rate of 26 breaths/min could signal increasing difficulty in breathing but needs to be considered alongside other signs of respiratory distress. Similarly, a blood pressure of 150/80 mmHg and a heart rate of 92 beats/min, while deserving attention, do not pose an immediate risk in the same way that a possible fever indicating infection does, particularly in the context of a COPD patient. Thus, the elevated oral temperature is the most critical vital sign requiring urgent attention.