A patient with COPD is receiving oxygen therapy. Which considerations are important to ensure safe and effective oxygen administration for this patient?
(Select All that Apply.)

Increase oxygen flow rate if the patient appears anxious.

Administer high-flow oxygen to quickly relieve hypoxemia.

Monitor the patient's respiratory rate and effort frequently.

Adjust oxygen flow rate to maintain a saturation level of 88-92%.

Use a non-rebreather mask to maximize oxygen delivery.

Encourage the patient to take deep breaths frequently.

Answer and Explanation

Correct Answer : C,D

A.   Increasing the oxygen flow rate due to anxiety can worsen carbon dioxide retention, which is dangerous in COPD patients.
B.   High-flow oxygen is typically not recommended for COPD patients because it can suppress respiratory drive.
C.   Monitoring the respiratory rate and effort is crucial to ensure the patient is not retaining carbon dioxide or experiencing further respiratory distress.
D.   Adjusting the oxygen flow rate to maintain a saturation level of 88-92% is recommended for COPD patients to prevent hypercapnia.
E.   A non-rebreather mask is generally not used for COPD patients, as it can deliver too much oxygen, leading to carbon dioxide retention.
F.   Encouraging deep breathing can help, but it is more important to focus on maintaining the proper oxygen saturation.

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Correct Answer is B

Explanation

A. Encouraging the patient to take deep breaths and cough would not address the underlying cause of the symptoms, which may indicate a more serious condition.
B. Administering oxygen to maintain adequate oxygenation is the most appropriate initial action, as the patient’s symptoms suggest a potentially life-threatening condition like a cardiac tamponade or pulmonary embolism.
C. Positioning the patient flat in bed is not recommended, as it may exacerbate breathing difficulties and
the patient’s distress.
D. A warm compress is unlikely to be beneficial in this acute situation and could delay appropriate intervention.

A. Administer an anti-diarrheal medication as prescribed to control the symptoms. B. Increase the water flushes to improve hydration and dilute the feeding solution. C. Switch the feeding tube to a bolus feeding method instead of continuous feeding. D. Decrease the feeding rate and consult the dietitian for a fiber-enriched formula.

Correct Answer is D

Explanation

A. Administering an anti-diarrheal medication as prescribed might help control the symptoms, but it is important to address the underlying cause of the diarrhea first, such as adjusting the feeding.
B. Increasing water flushes may help with hydration, but it does not specifically address the diarrhea caused by the enteral feeding. It's more important to manage the feeding itself.
C. Switching the feeding method to bolus feeding could increase the risk of aspiration and discomfort. Continuous feeding is generally safer and better tolerated in this context.
D. Decreasing the feeding rate and consulting the dietitian for a fiber-enriched formula is the most appropriate response. Adjusting the feeding rate can help reduce gastrointestinal upset, and a fiber- enriched formula can help firm up stools.

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(Select All that Apply.)