When caring for a patient with emphysema requiring supplemental oxygen, the nurse knows to carefully administer...

When caring for a patient with emphysema requiring supplemental oxygen, the nurse knows to carefully administer oxygen to the lowest effective dose in order to avoid

	A.	Tachycardia
	B.	Respiratory alkalosis
	C.	Hypoventilation
	D.	Obstructive apnea

Expert Solution

C- Hypoventilation

.When treating a patient with emphysema in the acute care setting who appears to be hypoxic, short of breath, and requires increased effort to breathe, be very careful before using oxygen therapy. In a normally functioning patient, the respiratory drive is largely directed by PaCO₂levels in the brain since H+ readily crossed the blood brain barrier.

In this patient, PaCO₂ becomes chronically elevated, and thus the body shifts its respiratory controllers to become more responsive to PaO₂levels. After this paradoxical shift, treating a chronic emphysema patient with oxygen increased the blood oxygen levels too rapidly. watch for signs of hypoventilation, a decreased level of consciousness, and apnea.This may result in knocking out his hypoxic drive, causing further depression of the respiratory drive.

Oxygen is essential to life, but as a drug it has both a maximum positive benefit and an accompanying toxicity effect. The toxic effects from oxygen therapy can occur based on the condition of the patient and the duration and intensity of the oxygen therapy. For example, with normal lung function, a stimulation to take another breath occurs when a patient has a slight rise in PaCO₂. The slight rise in PaCO₂ stimulates the respiratory centre in the brain, creating the impulse to take another breath. In some patients with a chronically high level of PaCO₂, such as those with chronic obstructive pulmonary disease (COPD), the stimulus and drive to breathe is caused by a decrease in PaO₂. This is called a hypoxic drive. When administering oxygen to patients with known CO₂ retention, watch for signs of hypoventilation, a decreased level of consciousness, and apnea.

Nightingale answered 2 years ago

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