The nurse is planning care for an 81-year-old unresponsive client admitted to the hospital with a medical diagnosis of pneumonia. The nurse has identified the problem of inability to clear the airway related to retained secretions. Which intervention is most appropriate?

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. Physical therapy for homebound therapy services:Physical therapy is not routinely indicated in TB management unless the patient has specific mobility deficits. TB treatment focuses more on medication adherence and infection control rather than physical rehabilitation.

B. Occupational therapy for job retraining:There is no direct indication for job retraining in a TB patient unless the illness has caused long-term disability or affected occupational function, which is not suggested in this scenario.

C. Community social worker for Meals on Wheels:Meals on Wheels may assist with nutrition, but it is not specific to TB care. Social services do not directly ensure adherence to TB therapy, which is crucial for treatment success and public health safety.

D. Visiting Nurses for directly observed therapy:Directly observed therapy (DOT) ensures the client takes prescribed TB medications under supervision, which is essential to prevent noncompliance, reduce drug resistance, and promote cure. Visiting nurses are best positioned to provide this support during long-term outpatient TB treatment.