A confused, lethargic, and nonverbal 50-year-old female has altered mental status. You are told she has a history of chronic obstructive pulmonary disease (COPD). The primary assessment reveals a breathing rate of 6 per minute and cool, clammy skin with cyanosis around the lips. Which of the following should be your next action?

Question

Quizplus · Accepted Answer

The patient's altered mental status and slow respiratory rate indicate respiratory failure, which is further supported by the history of COPD. Cyanosis around the lips and cool, clammy skin suggest hypoxia and possible shock. The best course of action is to assist the patient's breathing with positive pressure ventilation (B) to increase oxygenation and support perfusion until definitive treatment can be initiated. Administering oxygen by nasal cannula (A) or nonrebreather mask (C) alone may not be sufficient to correct the hypoxia and could worsen the hypercapnia (elevated carbon dioxide levels) commonly seen in patients with COPD. Sitting the patient up and assessing lung sounds (D) is important, but should not delay the immediate intervention needed to address the life-threatening respiratory failure.

A Confused, Lethargic, and Nonverbal 50-Year-Old Female Has Altered Mental