A client in the ED with status asthmaticus has RR 34/min and is using accessory muscles. After multiple nebulizer treatments, the wheezing disappears, RR drops to 14/min, and an ABG shows PaCO2 44 mmHg. How should the nurse interpret this change?

Question

Accepted Answer

C. Impending respiratory failure from fatigue — In severe asthma, wheezing can disappear when air movement becomes minimal (“silent chest”). A PaCO2 that returns to normal or rises despite clinical illness suggests ventilatory fatigue and impending respiratory failure—prepare for rapid escalation (RT/rapid response, possible intubation).

Answer

A. The asthma exacerbation is resolving

Answer

B. The bronchodilators are working as expected

Answer

D. The client is relaxing and will sleep soon