A client is extubated in the postanesthesia care unit after surgery. For which common response would the nurse be alert when monitoring the client for acute respiratory distress?

A client is extubated in the postanesthesia care unit after surgery. For which common response would the nurse be alert when monitoring the client for acute respiratory distress?

• A. Restlessness
• B. Bradycardia
• C. Constricted pupils
• D. Clubbing of the fingers

Answer: (A)

Restlessness after extubation is an early warning sign that the brain isn’t receiving enough oxygen, signaling acute respiratory distress. When airway patency is compromised, ventilation is inadequate, and hypoxemia or rising CO2 can trigger agitation or anxiety as the body tries to wake and respond. In the PACU setting, this restless state often accompanies other signs like increased work of breathing or changes in oxygen saturation, making it a key cue to assess airway patency, breathing effort, and need for intervention. The other options don’t fit as typical acute respiratory distress indicators. Bradycardia is not common when oxygenation is acutely compromised—tachycardia is more typical as the heart tries to compensate. Constricted pupils are not related to respiratory status, and clubbing of the fingers is a chronic finding indicating long-standing hypoxia, not an acute post-extubation event.

Restlessness after extubation is an early warning sign that the brain isn’t receiving enough oxygen, signaling acute respiratory distress. When airway patency is compromised, ventilation is inadequate, and hypoxemia or rising CO2 can trigger agitation or anxiety as the body tries to wake and respond. In the PACU setting, this restless state often accompanies other signs like increased work of breathing or changes in oxygen saturation, making it a key cue to assess airway patency, breathing effort, and need for intervention.

The other options don’t fit as typical acute respiratory distress indicators. Bradycardia is not common when oxygenation is acutely compromised—tachycardia is more typical as the heart tries to compensate. Constricted pupils are not related to respiratory status, and clubbing of the fingers is a chronic finding indicating long-standing hypoxia, not an acute post-extubation event.