A COPD patient is on home oxygen and has SpO2 94% on 2 L/min. What is the appropriate nursing action?

• A. Increase oxygen to 3 L/min.
• B. Maintain the current prescription, monitor for CO2 retention.
• C. Discontinue home oxygen.
• D. Switch to a noninvasive ventilation device.

Answer: (D)

In COPD, oxygen therapy must be titrated to keep SpO2 in a safe range without driving CO2 retention. A SpO2 of 94% on 2 L/min shows the patient is adequately oxygenated on the current flow. Increasing the oxygen could raise the risk of CO2 retention and respiratory acidosis, since higher O2 levels can blunt the hypoxic drive and worsen V/Q mismatch. Noninvasive ventilation is used for patients with ventilatory failure or chronic hypercapnic respiratory failure who need ventilatory support, not for a stable patient who is already adequately oxygenated on home oxygen. So the best nursing action is to maintain the current oxygen prescription and monitor for signs of CO2 retention, with reassessment (including ABG if symptoms arise or trends change).