A 52-Year-Old Male with a Medical History of Congestive Heart

A 52-year-old male with a medical history of congestive heart failure and hypertension arrives in the emergency department because of an acute onset of dyspnea.The patient has pink frothy secretions at the mouth.A rapid physical assessment reveals a pulse of 128 beats/min,respiratory rate 28 breaths/min and labored,and blood pressure 82/56 mm Hg.Bilateral coarse crackles are heard in the lung bases.Arterial blood gas results on a 12 L/min nonrebreather mask are: pH 7.32,PₐCO₂ 49 mm Hg,PₐO₂ 50 mm Hg,arterial SₐO₂ 74%.The most appropriate immediate action for this patient is which of the following?

A) Intubation and mechanical ventilation
B) Increase flow to the nonrebreather mask
C) Continuous positive airway pressure via mask
D) Nasotracheal suctioning and a high flow nasal cannula