A patient with chronic obstructive pulmonary disease (COPD) tells the nurse that he does not always wear the prescribed oxygen at home because it is cumbersome and he is rarely short of breath

Question

What is the nurse's best response to this patient? 1. "Wearing the oxygen will help keep your blood oxygen saturation levels up so your heart does not have to work as hard and will not become enlarged.".
2. "You really should wear it at least while sleeping.".
3. "You do seem to be doing fine without it.".
4. "Keep the oxygen at home and if you become short of breath, you know to put it on until you are able to breathe normally again.".

Answer 1

1
Rationale 1: The nurse should instruct the patient on the benefit of using long-term oxygen therapy to prevent polycythemia vera, an increase in the hematocrit level above normal as a compensatory mechanism to hypoxia. Cor pulmonale, an enlargement of the right side of the heart, can also develop and can lead to mortality in the patient with COPD.
Rationale 2: The nurse should encourage the patient to wear the oxygen at all times and not just during sleep.
Rationale 3: It may be misleading to state the patient is doing fine without the oxygen.
Rationale 4: The nurse should not instruct the patient to wear the oxygen just when he becomes short of breath but to wear it at all times as prescribed.