Final answer:
Oxygen therapy for a COPD patient should be managed with careful monitoring using a pulse oximeter to maintain an adequate level of oxygenation that ensures gas exchange without suppressing the patient's drive to breathe.
Step-by-step explanation:
The principle that should guide the nurse in managing the delivery of oxygen therapy to a client with chronic obstructive pulmonary disease (COPD) includes maintaining the optimal level of oxygenation while being cautious of the body's adaptive mechanisms to chronic hypoxemia. COPD patients often have a reduced capacity for gas exchange due to alveolar damage. The breakdown of alveolar walls, which leads to a loss of elasticity and surface area for gas exchange, hampers the ability of the lungs to oxygenate blood and remove carbon dioxide. The nurse must manage oxygen delivery precisely because providing too much oxygen can diminish the drive to breathe in patients adapted to higher levels of carbon dioxide. Therefore, it is crucial to monitor blood oxygen levels, usually with a pulse oximeter, to ensure adequate oxygenation without causing respiratory drive suppression.
Oxygen therapy must be titrated based on the patient's oxygen saturation levels and clinical signs of hypoxemia, such as changes in mental status, cyanosis, or tachycardia. The goal is to maintain oxygen saturation above 88-92% or as prescribed by the physician, ensuring that oxygen is diffusing efficiently across the respiratory membrane by paying close attention to the partial pressure of gases and the patient's overall respiratory function.