A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2 L/min via nasal cannula. After assessing the patient, the nurse notes increased drowsiness and a decreased respiratory rate. What is the most appropriate action for the nurse to take?

Increase the oxygen flow rate to 4 L/min to improve oxygenation.

Switch the patient to a non-rebreather mask for better oxygenation.

Continue to monitor the patient closely and reassess in 30 minutes.

Reduce the oxygen flow rate to 1 L/min and notify the healthcare provider.

Answer and Explanation

The Correct Answer is D

A.   Increasing the oxygen flow rate could worsen respiratory depression in patients with COPD, as they rely on low oxygen levels to stimulate breathing.
B.   Switching to a non-rebreather mask could further elevate the oxygen levels and may lead to hypoventilation or respiratory distress.
C.   Monitoring the patient closely and reassessing in 30 minutes might be appropriate if the patient shows no immediate signs of respiratory distress, but the priority is to address the decreased respiratory rate.
D.   Reducing the oxygen flow rate to 1 L/min and notifying the healthcare provider is the most appropriate action, as it may reduce the risk of respiratory depression caused by excessive oxygen.

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Correct Answer is ["A","B","C"]

Explanation

A. A Venturi mask is an accurate way to deliver a specific concentration of oxygen, allowing for precise control.
B. Humidifying oxygen is recommended at flow rates higher than 4 liters per minute to prevent drying of the mucous membranes.
C. Oxygen toxicity can occur if high concentrations of oxygen are administered for prolonged periods, leading to potential lung damage.
D. Nasal cannulas typically provide a lower oxygen concentration than higher-flow devices, like a Venturi mask or non-rebreather mask.
E. Oxygen therapy is not always entirely safe regardless of the patient's condition; certain conditions require careful monitoring to prevent complications.

A. Use sterile water to flush the tube before and after feeding. B. Lower the head of the bed to 15 degrees to facilitate feeding. C. Change the feeding bag and tubing every 24 hours. D. Check for residual volume before each feeding E. Add crushed medications to the enteral formula for convenience. F. Administer the feeding in a continuous cycle over 24 hours.

Correct Answer is ["C","D"]

Explanation

A. Using sterile water is recommended for flushing the tube before and after feeding, but it is not the most critical step in preventing complications.
B. Lowering the head of the bed to 15 degrees during feeding may increase the risk of aspiration, as a higher elevation is typically recommended.
C. Changing the feeding bag and tubing every 24 hours helps prevent bacterial contamination and reduces the risk of infection.
D. Checking for residual volume before each feeding helps ensure that the stomach is empty, reducing the risk of aspiration.
E. Adding crushed medications to the enteral formula is not recommended, as it can alter the formula's absorption and cause clogging of the tube.
F. Administering the feeding in a continuous cycle over 24 hours is typically done for certain patients, but it is not essential to prevent complications in all cases.

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A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2 L/min via nasal cannula. After assessing the patient, the nurse notes increased drowsiness and a decreased respiratory rate. What is the most appropriate action for the nurse to take?

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Correct Answer is ["A","B","C"]

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