In a patient with emphysema who is showing shallow respirations at 22/min and 95% SpO2, what should the therapist do?

• A. Increase oxygen flow rate to 6 L/min
• B. Notify the physician
• C. Reduce oxygen flow rate to 1 L/min
• D. Change to a nonrebreathing mask

Answer: (C)

In patients with emphysema, which is a type of chronic obstructive pulmonary disease (COPD), there is often a sensitivity to oxygen levels due to their altered respiratory drive. These patients typically have a history of chronically elevated carbon dioxide (CO2) and rely on low levels of oxygen as their primary stimulus to breathe. Therefore, administering too much oxygen can potentially suppress their natural drive to breathe, leading to respiratory complications.

Reducing the oxygen flow rate to 1 L/min in this scenario aligns with the goal of providing sufficient oxygen without overwhelming the patient's respiratory drive. Maintaining a more controlled and lower oxygen supplementation helps to ensure that the patient receives adequate oxygenation while minimizing the risk of carbon dioxide retention and potential respiratory depression.

Increasing the oxygen flow rate could lead to oxygen toxicity and further suppress the patient's breathing effort. Notifying the physician may be necessary in some cases, but adjusting the oxygen flow rate is a more immediate intervention for the respiratory status observed. Switching to a nonrebreathing mask, which typically provides high levels of oxygen, would not be appropriate given the patient's COPD condition and risk of respiratory depression.