The patient presents to the emergency department after having a metal beam fall on his head at a work site. He was wearing a helmet which broke with the impact. He was unconscious at the scene but is awake now, and his initial assessment is completely benign. Which finding upon reassessment 30 minutes later is most concerning?

The patient’s father is observed pressing the patient’s patient-controlled analgesia (PCA) pump while the patient is asleep. The nurse attempts to arouse the patient, who only opens the eyes after being pinched. Once aroused, the patient is able to raise the hand upon request. When asked what the year is, the patient responds with the previous year. The nurse reports the patient’s condition to the provider with which number on the Glasgow Coma Scale? Enter your response using a whole number.

During routine tracheostomy cleaning and care, the nurse notes a strong smell of dirty gym socks coming from the dressing around the stoma. Which action by the nurse is most appropriate?