Final answer:
Correct option:b) a patient with an spO₂ of 90% who says that they have copd and normally have a low pulse oximeter reading.
Patient B with COPD and an SpO₂ of 90%, who normally has a low reading, does not necessarily need oxygen as COPD patients often have a different percent saturation baseline. However, each patient case is unique and requires an individual assessment to determine the need for oxygen therapy.
Step-by-step explanation:
The patient who does not necessarily need oxygen among the options provided is patient B, with an SpO₂ of 90% who has chronic obstructive pulmonary disease (COPD) and normally runs on a low pulse oximeter reading. This is because patients with COPD often have a different baseline for their percent saturation measurements, and an SpO₂ of 90% might be within their normal range. It is crucial to understand the patient's normal baseline and clinical picture before administering supplemental oxygen.
It is worth mentioning that every patient case is unique and a thorough assessment by healthcare professionals is required to determine the need for oxygen therapy. For instance, patient A, even with a high SpO₂, might need oxygen if the accessory muscle use indicates respiratory distress. Patients C and D might also need oxygen depending on other clinical factors, such as the altered mental status in patient C or the need to maintain a certain oxygenation level for patient D who is about to go through dialysis.
Oxygen therapy should be tailored to the individual needs of the patient, taking into account their specific medical condition and monitoring them for any signs of respiratory distress or hypoxemia.