Answer:
Option B, instruct the client to breathe into a paper bag
Explanation:
During this panic attack, the patient's respiratory rate has skyrocketed to 46 breaths per minute, a symptom known as tachypnea, or fast breathing. At this rate, it can also be called as hyperventilation. This higher rate of breathing means the patient is blowing off more carbon dioxide (CO₂) than normal which, in turn, means less CO₂ is available to be converted to carbonic acid within the body, leading to an increase in the pH of the blood, hence the state of respiratory alkalosis.
By having the patient breathe into a paper bag, they are breathing back in the same CO₂ they are exhaling so vigorously due to their hyperventilation, thereby helping to self-regulate the pH disturbance. In practice, it is not as effective as theorized, however, it is the easiest and most clear nursing intervention of the option choices.
The patient is not having oxygen saturation and or issues with oxygen perfusion, thus oxygen delivered via nasal cannula is not indicated. The administration of albuterol inhaler requires a provider's prescription, and is also not indicated because the patient is not noted as showing signs of airway compromise. Lastly, administering sodium bicarbonate would also require provider order, and it is contraindicated in this situation; bicarbonate is basic and, for a patient with respiratory alkalosis, this would only serve to propel them towards an even more basic state, which is not what is desired to remedy the pH imbalance.
Therefore, the best action the nurse should implement is option B, instruct the client to breathe into a paper bag.