Question

A client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory unit. Which physician prescription should the nurse question?

O2 at 5L/min by nasal cannula
Solu Medrol 125mg IV push every six hours
Ceftriaxone (Rocephin) 1gram IVPB daily
Darvocet N 100 po prn pain

Answer 1

The nurse should question the prescription for O2 at 5L/min via nasal cannula for a COPD patient due to the risk of reduced respiratory drive and potential carbon dioxide retention.

Step-by-step explanation:

The nurse should question the prescription for O2 at 5L/min by nasal cannula for a client with Chronic Obstructive Pulmonary Disease (COPD). COPD patients usually require a carefully titrated oxygen supply because their respiratory drive is often dependent on hypoxic drive.

A high flow of oxygen, such as 5 liters per minute, may decrease the patient's respiratory drive, leading to an increased risk of carbon dioxide retention and respiratory acidosis. Therefore, oxygen therapy in COPD patients should be managed cautiously, with the goal of maintaining the oxygen saturation (SpO2) typically between 88-92%. The other prescriptions listed, including Solu Medrol for its anti-inflammatory effects, Ceftriaxone (Rocephin) as an antibiotic, and Darvocet N 100 for pain relief, are appropriate for the management of a COPD exacerbation or associated conditions.