A patient presents to the emergency department in acute respiratory failure secondary to community-acquired pneumonia. The patient has a history of chronic obstructive pulmonary disease
The nurse anticipates which treatment to facilitate ventilation? a. Emergency tracheostomy and mechanical ventilation
b. Mechanical ventilation via an endotracheal tube
c. Noninvasive positive-pressure ventilation (NPPV)
d. Oxygen at 100% via bag-valve-mask device
C
Noninvasive measures are often recommended in the initial treatment of the patient with chronic obstructive pulmonary disease to prevent intubation and ventilator dependence. The history of chronic obstructive pulmonary disease increases the risk for ventilator dependence, so noninvasive options are a priority. Bag-valve ventilation with 100% oxygen is not required at this time and could depress the respiratory drive that exists. Emergency tracheostomy is not indicated, as there is an indication of an obstructed airway.
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