The health care provider has ordered a hypotonic intravenous (IV) solution to be administered. Which IV bag will the nurse prepare?

A. Metabolic acidosis is characterized by a primary decrease in bicarbonate (HCO₃⁻) levels, which is not typically a direct result of COPD. However, if a patient with COPD has an additional condition like kidney failure or severe sepsis, they could potentially develop metabolic acidosis. But, this is not the primary concern in COPD.
B. Respiratory alkalosis is caused by hyperventilation, where there is excessive loss of CO₂ leading to an increase in blood pH. This is less common in COPD patients, as they typically have difficulty exhaling CO₂ rather than hyperventilating.
C. Metabolic alkalosis involves an increase in blood pH due to elevated bicarbonate levels or loss of acid. This is not typically associated with COPD, unless there is an unrelated condition causing metabolic alkalosis.
D. COPD is characterized by impaired airflow and reduced ability to expel carbon dioxide (CO₂) effectively. As CO₂ accumulates in the blood, it combines with water to form carbonic acid, which lowers the blood pH, leading to respiratory acidosis.

A. Lubricating the suction catheter tip with sterile saline is generally not recommended. The catheter tip is usually not lubricated before suctioning. Instead, suctioning should be performed using a dry, sterile catheter to prevent introducing any substances into the airway that could cause irritation or infection.
B. Hyperoxygenating the patient with 100% oxygen before suctioning is a crucial step. This helps to prevent hypoxia during the suctioning procedure, as suctioning can temporarily reduce the oxygen levels in the blood. By providing 100% oxygen for 30 to 60 seconds, the nurse ensures that the patient has an adequate oxygen reserve and reduces the risk of oxygen desaturation during suctioning.
C. Performing chest physiotherapy is not a routine pre-suctioning action and is generally done as part of a separate management strategy for clearing secretions. Chest physiotherapy involves techniques such as percussion, vibration, and postural drainage to help mobilize secretions from the lungs.
D. Instilling normal saline into the airway before suctioning (known as “normal saline lavage”) is not recommended. This practice can actually cause harm, such as increasing the risk of infection, causing bronchospasm, and diluting secretions which may then become more difficult to suction.