Author Question: A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on ... (Read 123 times)

maegan_martin · **on:** Jun 25, 2018

A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on oxygen therapy. Which instruction should the nurse include in the discharge teaching?

a. Storage of oxygen tanks will require adequate space in the home.
b. Travel opportunities will be limited because of the use of oxygen.
c. Oxygen flow should be increased if the patient has more dyspnea.
d. Oxygen use can improve the patient's prognosis and quality of life.

Question 2

The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD).What is the best way for the nurse to determine the appropriate oxygen flow rate?

a. Minimize oxygen use to avoid oxygen dependency.
b. Maintain the pulse oximetry level at 90 or greater.
c. Administer oxygen according to the patient's level of dyspnea.
d. Avoid administration of oxygen at a rate of more than 2 L/minute.

adf223 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
The use of home oxygen improves quality of life and prognosis. Because increased dyspnea may be a symptom of an acute process such as pneumonia, the patient should notify the physician rather than increasing the oxygen flow rate if dyspnea becomes worse. Oxygen can be supplied using liquid, storage tanks, or concentrators, depending on individual patient circumstances. Travel is possible using portable oxygen concentrators.

Answer to Question 2

ANS: B
The best way to determine the appropriate oxygen flow rate is by monitoring the patient's oxygenation either by arterial blood gases (ABGs) or pulse oximetry. An oxygen saturation of 90 indicates adequate blood oxygen level without the danger of suppressing the respiratory drive. For patients with an exacerbation of COPD, an oxygen flow rate of 2 L/min may not be adequate. Because oxygen use improves survival rate in patients with COPD, there is no concern about oxygen dependency. The patient's perceived dyspnea level may be affected by other factors (such as anxiety) besides blood oxygen level.