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학습 자료 둘러보기 →In a patient with acute exacerbation of COPD, new onset restlessness and irritability are not signs of simple anxiety; they are early neurological indicators of worsening hypoxemia and hypercapnia. This signals failure of the current oxygen therapy and potential progression to CO2 narcosis.
The priority intervention is to notify the healthcare provider immediately. A change in mental status represents a clinical deterioration that requires urgent medical assessment and new orders. The nurse must not independently adjust oxygen delivery.
Do not independently increase the FiO2 (e.g., raising flow rate or switching to a mask) in a COPD patient with altered mental status. This can suppress the hypoxic drive, leading to dangerous respiratory acidosis and worsening consciousness. Target an SpO2 of 88-92% only with a provider's order.
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