A nurse is caring for a client receiving hospice care who is in the final stages of dying. The client's son appears alarmed and reports that his father is making unusual sounds when breathing. What is the best response from the nurse?

End-of-life respiratory changes involve terminal secretions, reduced cough reflex, hypoxic respiratory drive suppression, and irregular breathing patterns such as Cheyne-Stokes respiration caused by progressive multi-organ failure and neurologic decline process. Rationale: A. Increasing oxygen therapy addresses hypoxemia but not terminal secretions. End-of-life noisy breathing results from airway secretion accumulation. Oxygen therapy does not resolve reduced swallowing or cough reflex dysfunction. Comfort measures and positioning are preferred evidence-based hospice care interventions for management. B. Calling respiratory therapist is unnecessary in expected end-of-life breathing changes. This condition reflects physiological dying process rather than acute respiratory distress. Therapists do not modify terminal secretions effectively. Primary intervention focuses on comfort care and family education ongoing support provision. C. Requesting suctioning for noisy breathing is generally not recommended in hospice care. This sound is caused by pooled oropharyngeal secretions during reduced consciousness. Suctioning may cause mucosal trauma and increased patient discomfort. Comfort repositioning and anticholinergics are palliative options used. D. Noisy breathing at end of life is commonly known as death rattle. It results from accumulation of oropharyngeal and tracheobronchial secretions. It does not usually indicate pain or respiratory distress. Reassurance and education improve family understanding and reduce anxiety levels.