A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the health care provider, should the nurse question?

A. The client's sodium and chloride levels will rise:CO₂ retention affects acid-base balance more directly than it affects electrolyte concentrations like sodium or chloride. Changes in these levels may occur in severe or chronic cases, but they are not the initial response.

B. The client's arterial blood gas results will reflect acidosis:When CO₂ accumulates in the blood due to hypoventilation, it forms carbonic acid, lowering blood pH. This results in respiratory acidosis, which is typically the earliest and most direct physiological response to CO₂ retention.

C. The client will lose consciousness:Loss of consciousness may occur if CO₂ levels rise dramatically and go uncorrected. However, this is a late sign of severe respiratory failure, not the initial or most sensitive indicator.

D. The client will complain of facial numbness and tingling:These symptoms are more characteristic of respiratory alkalosis, often due to hyperventilation, not CO₂ retention. In respiratory acidosis, symptoms are more likely to include drowsiness, confusion, or headache.

A. Determining the last time the patient was suctioned:The timing of previous suctioning is not a reliable indicator of current need. Suctioning is a clinical decision based on assessment, not a fixed schedule or time interval.

B. Auscultating the breath sounds:Listening to lung sounds helps detect the presence of secretions, such as crackles or rhonchi, indicating airway obstruction. This is the most direct and effective method to assess the need for suctioning in a tracheostomized patient.

C. Monitoring the rate of respirations:An increased respiratory rate can suggest respiratory distress but is non-specific and may result from various causes, including anxiety, fever, or pain. It does not definitively indicate the presence of secretions.

D. Examining the character of the sputum:Sputum characteristics provide information about infection or hydration status, but unless secretions are visibly present or obstructing the airway, they don’t confirm the immediate need for suctioning.