Endothelium
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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 others). Other assessments: respiratory rate/effort; accessory muscle use; pursed-lip breathing; sputum; fluid balance (overload risk with cor pulmonale); activity tolerance. COPD management: bronchodilators; corticosteroids; pulmonary rehab; energy conservation; smoking cessation; vaccination; exacerbation management. Nurses educate about: inhaler technique; breathing exercises; symptom monitoring; when to seek help. Acute exacerbations may require hospitalization for controlled oxygen, nebulizers, steroids, antibiotics if infection, possibly non-invasive ventilation. Careful oxygen titration balances oxygenation with respiratory drive preservation.
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