Monitoring for oxygen-induced hypoventilation (oxygen-induced hypercapnia) is critical in COPD patients who may have chronic carbon dioxide retention and rely on hypoxic drive for breathing. Signs: decreased respiratory rate; increased somnolence; headache; confusion. Oxygen should be titrated to maintain saturation 88-92% (not necessarily >94% as in other patients). Other assessments: respiratory rate/effort; use of accessory muscles; pursed-lip breathing; sputum characteristics; fluid balance (overload risk with cor pulmonale); and activity tolerance. COPD management includes: bronchodilators; corticosteroids; pulmonary rehabilitation; energy conservation; smoking cessation; vaccination; and exacerbation management. Nurses educate about: proper inhaler technique; breathing exercises; symptom monitoring; and when to seek help. Acute exacerbations may require hospitalization for controlled oxygen, nebulizers, steroids, antibiotics if infection present, and possibly non-invasive ventilation.

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Zambia

• loveness Phiri – 1084 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies