A client with chronic respiratory acidosis is receiving oxygen by nasal cannula at 6 L/min. The client's respiratory rate is 8 breaths/min. Which action by the nurse is the priority?

Question

a. Notify the Rapid Response Team and prepare for intubation.
b. Change the nasal cannula to a mask and reassess in 10 minutes.
c. Place the client in Fowler's position if he or she is able to tolerate it.
d. Decrease the flow rate of oxygen to 2 to 4 L/min, and reassess.

Answer 1

A
The primary trigger for respiration in a client with chronic respiratory acidosis is a decreased arterial oxygen level (hypoxic drive). Oxygen therapy can inhibit respiratory efforts in this case, eventually causing respiratory arrest and death. The nurse could decrease the oxygen flow rate; eventually, this might improve the client's respiratory rate, but the priority action would be to call the Rapid Response Team whenever a client with chronic carbon dioxide retention has a respiratory rate less than 10 . Changing the cannula to a mask does nothing to improve the client's hypoxic drive, nor would it address the client's most pressing need. Positioning will not help the client breathe at a normal rate nor maintain client safety.