When dealing with a client experiencing acute respiratory distress, what should the nurse do immediately?

Placing the client in high Fowler's position is the most appropriate immediate intervention for a client experiencing acute respiratory distress. This position helps to maximize lung expansion and facilitates better oxygenation by pulling the diaphragm down and allowing the lungs greater room to expand. When a patient is in a high Fowler's position, gravity assists in lung inflation, making it easier for the patient to breathe, especially if they are struggling with shortness of breath.

In contrast, encouraging deep breathing and coughing may not be beneficial if the client is in acute distress, as these actions can be tiring and may exacerbate the respiratory struggle. Maintaining a side-lying position, while sometimes helpful in specific scenarios, does not optimize airway management or lung capacity as effectively as the upright position. Pursed-lip breathing can be useful for clients with chronic respiratory issues but might not provide the immediate relief and support needed during an acute episode. Thus, high Fowler's position is the best initial choice for improving airflow and comfort in acute respiratory distress situations.