A 56-year-old female with a smoking history and COPD complains of the sudden onset of shortness of breath and diaphoresis. History indicates no cardiac diagnosis but previous drug abuse 8 years ago. Vital signs are: pulse 96, respiration 18 and mildly labored, blood pressure 168/102 mmHg, and SpO₂ 94% on home oxygen at 4 lpm, which she wears for COPD. Her lung sounds are clear but diminished bilaterally. You would:

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The patient's presentation indicates a possible exacerbation of COPD, which can be worsened with high levels of oxygen, leading to hypercapnia and respiratory acidosis. Therefore, the oxygen should be turned down to 2 lpm. Additionally, the elevated blood pressure suggests possible hypertension, so it would be appropriate to monitor the patient's blood pressure throughout transport. Aspirin would not be indicated in this case as there is no clear indication for a thrombotic event. Administering the patient's MDI may be appropriate, but it is not a high priority intervention in this case. Nitroglycerin would not be appropriate as there is no clear indication of cardiac chest pain.

A 56-Year-Old Female with a Smoking History and COPD Complains