A 64-Year-Old Female Patient Having an Acute Exacerbation of Chronic

A 64-year-old female patient having an acute exacerbation of chronic obstructive pulmonary disease (COPD) was admitted to the hospital yesterday.During rounds today the respiratory therapist finds the patient to be difficult to arouse and has the following physical findings: heart rate 102 beats/min,respiratory rate 23 breaths/min shallow and slightly labored,breath sounds are bilaterally decreased with rhonchi in both bases.The patient has a frequent butweak cough. The respiratory therapist draws an ABG with the following results on a 2 L/min nasal cannula: pH 7.52, P_aCO₂ 30 mm Hg, P_aO₂ 45 mm Hg, S_aO₂ 86%, HCO₃^- 24 m Eq/L. The most appropriate action is which of the following?

A) Intubate and mechanically ventilate.
B) Increase the nasal cannula to 4 L/min.
C) Administer incentive spirometry.
D) Begin noninvasive positive pressure ventilation.

Correct Answer:

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