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학습 자료 둘러보기 →In acute exacerbation of COPD, the patient's trajectory can change rapidly. The nursing process mandates that assessment is the highest priority unless the patient is in a life-threatening crisis. For a patient already on oxygen and bronchodilators, the nurse must first evaluate the effectiveness of current therapies.
Closely monitor respiratory status, including rate, depth, effort, and breath sounds. Obtain arterial blood gases (ABGs) to objectively evaluate oxygenation (PaO2), ventilation (PaCO2), and acid-base balance. An SpO2 of 88% corresponds to a PaO2 of approximately 55 mmHg, indicating significant hypoxemia.
Do not increase oxygen flow rate without ABG assessment. In CO2 retainers, over-oxygenation can suppress the hypoxic drive, leading to hypoventilation, rising PaCO2, and acute respiratory failure. Titrate O2 to a target SpO2 of 88-92%.
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