Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath?

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. "I have cared for patients who were able to have the tracheostomy reversed. While this may offer hope, it shifts the focus to long-term outcomes rather than addressing the patient's current emotional state. Not all tracheostomies are reversible, and offering this reassurance prematurely may set unrealistic expectations.

B. “I understand that you might be apprehensive." This statement acknowledges the patient's anxiety and fosters trust. Demonstrating empathy helps reduce emotional distress, encourages open communication, and supports emotional adaptation to the tracheostomy.

C. “I will be efficient and give care quickly." Although efficiency is important, this response may come off as dismissive of the patient's emotional needs. It prioritizes task completion over patient-centered care and fails to address the underlying anxiety.

D. "I will wait until your tracheostomy heals before teaching." Teaching should begin early, even in small steps, to help the patient gradually understand and adapt to tracheostomy care. Delaying education may increase fear, uncertainty, and dependence on others for care.